Zusammenfassung
Vaskulitiden, die im Rahmen anderer zugrunde liegender Erkrankungen auftreten, werden als sekundäre Vaskulitiden bezeichnet. In der breiten Differenzialdiagnostik der Vaskulitiden ist eine Vielzahl sekundärer Vaskulitiden zu bedenken. Sekundäre Vaskulitiden sind im gesamten Spektrum der Vaskulitiden mit entsprechend vielfältiger klinischer Manifestation vertreten. Der vorliegende Beitrag bietet eine Übersicht von Systemerkrankungen und ätiologischen Faktoren, wie Infektionen, Medikamenten und Malignomen, die mit Vaskulitiden assoziiert sein können. Die Assoziationen mit infektiösen Erregern sind enorm breit gefächert und können hier nur in Ansätzen aufgezeigt werden, ohne Anspruch auf Vollständigkeit und schwerpunktmäßig aus westeuropäischer Perspektive. Insbesondere bei atypischen oder refraktären Verläufen empfiehlt sich die Reevaluation einer sekundären Genese. In Anbetracht der Vielfalt an Differenzialdiagnosen und der besonderen Herausforderung sekundärer Vaskulitiden ist die interdisziplinäre Zusammenarbeit für eine korrekte und frühzeitige Diagnose und für das therapeutische Management entscheidend. Im Vordergrund steht immer die Therapie der zugrunde liegenden Erkrankung bzw. die sofortige Beendigung der Medikation bei Verdacht auf eine medikamenteninduzierte Vaskulitis.
Abstract
Vasculitides that occur in association with underlying primary diseases are called secondary vasculitides. In the diverse differential diagnostics of vasculitides, a large variety of secondary vasculitides have to be considered. Secondary vasculitides cover the full spectrum of vasculitides, presenting in manifold clinical manifestations. This article provides an overview of systemic diseases and etiological factors, such as infections, drugs, and malignancies, which can be associated with vasculitides. The possible associations with infectious agents are too numerous to be comprehensively covered and are discussed in an exemplary fashion and with a western European focus. Especially in atypical and refractory disease courses, a secondary vasculitis should be considered. In light of the diversity of differential diagnoses and the particular challenges posed by secondary vasculitides, interdisciplinary collaboration is the key for an accurate and early diagnosis as well as for successful treatment management. Treatment of the primary disease should always be prioritized and, if a drug-induced vasculitis is suspected, immediate cessation of the culprit drug is mandatory.
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K. Rose und C. Iking-Konert geben an, dass kein Interessenkonflikt besteht.
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Rose, K., Iking-Konert, C. Sekundäre Vaskulitiden. Innere Medizin 65, 129–136 (2024). https://doi.org/10.1007/s00108-023-01654-3
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DOI: https://doi.org/10.1007/s00108-023-01654-3
Schlüsselwörter
- Vaskulitis/Differenzialdiagnostik
- Systemerkrankungen
- Vaskulitis/Infektionen
- Medikamenteninduzierte Vaskulitiden
- Malignome