Skip to main content

Advertisement

Log in

Classification of the vasculitides: Are they clinically useful?

  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Several classification systems for the vasculitides have been developed over the second half of the past century. These classifications systems have been modified according to the advances made in the differentiation of these syndromes, particularly their histopathologic features (the vessel size involved) and their clinical features. Although these classifications have been widely used in the clinical setting for the diagnosis of these disorders, they were developed for research purposes. Given the common clinical and, sometimes, histopathologic features of the different vasculitides, a classification system that facilitates a diagnosis and the formulation of a therapeutic plan is still needed. The development and utilization of novel serum markers and new imaging modalities coupled with advances in the understanding of these disorders, may allow the development of a classification system for the vasculitides that will be of greater value in the clinical setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Matteson EL: Notes on the history of eponymic idiopathic vasculitis: the diseases of Henoch and Schonlein, Wegener, Churg and Strauss, Horton, Takayasu, Behcet, and Kawasaki. Arthritis Care Res 2004, 13:237–245.

    Article  Google Scholar 

  2. Lie JT: Nomenclature and classification of vasculitis: plus ça change, plus c’est la même chose. Arthritis Rheum 2004, 37:181–186. This is an editorial addressing the lack of important advances made in the most recent classification systems for the vasculitides.

    Article  Google Scholar 

  3. Matteson EL: Historical perspective of vasculitis: polyarteritis nodosa and microscopic polyangiitis. Curr Rheumatol Rep 2002, 4:67–74.

    Article  PubMed  Google Scholar 

  4. Jennette JC, Falk RJ: Clinical and pathological classification of ANCA-associated vasculitis: what are the controversies? Clin Exp Immunol 1995, 101:18–22.

    Article  PubMed  Google Scholar 

  5. Alarcón-Segovia D: The necrotizing vasculitides. A new pathogenetic classification. Curr Rheumatol Rep 1977, 5:93–99.

    Google Scholar 

  6. Matteson EL: Historical perspective on the classification of vasculitis. Arthritis Care Res 2000, 13:122–127.

    Article  PubMed  CAS  Google Scholar 

  7. Luqmani R, Robinson H: Introduction to, and classification of, the systemic vasculitides. Best Pract Res Clin Rheumatol 2001, 15:187–202.

    Article  PubMed  CAS  Google Scholar 

  8. Scott DG, Watts RA: Classification and epidemiology of systemic vasculitis. Br J Rheumatol 1994, 33:897–900. In this editorial a new classification for the vasculitides is proposed that overcomes some of the limitations other classification systems have.

    Article  PubMed  CAS  Google Scholar 

  9. Jenette JC, Falk RJ: Do vasculitis categorization systems really matter? Curr Rheumatol Rep 2000, 2:430–438. In this review the authors address the prognostic and treatment differences between the different vasculitides to warrant the development of diagnostic categories.

    Article  Google Scholar 

  10. Guillevin L, Lhote F: Classification and management of necrotizing vasculities. Drugs 1997, 53:805–816.

    PubMed  CAS  Google Scholar 

  11. Watts RA, Scott DGI: Classification and epidemiology of the vasculitides. Baillieres Clin Rheumatol 1997, 11:191–217.

    Article  PubMed  CAS  Google Scholar 

  12. Gonzalez-Gay MA, Garcia-Porrua C: Epidemiology of the vasculitides. Rheum Dis Clin North Am 2001, 27:729–749.

    Article  PubMed  CAS  Google Scholar 

  13. Jennette JC, Falk RJ: Small-vessel vasculitis. N Engl J Med 1997, 337:1512–1523.

    Article  PubMed  CAS  Google Scholar 

  14. Lie JT: Histopathologic specificity of systemic vasculitis. Rheum Dis Clin North Am 1995, 21:883–909.

    PubMed  CAS  Google Scholar 

  15. Zeek PM: Periarteritis nodosa: a critical review. Am J Clin Pathol 1952, 22:777–790.

    PubMed  CAS  Google Scholar 

  16. Heller I, Isakov A, Blinder-Weiner S, Topilsky M: Bayesian classification of vasculitis: a simulation study. Methods Inf Med 1995, 34:259–265.

    PubMed  CAS  Google Scholar 

  17. Rao JK, Allen NB, Pincus T: Limitations of the 1990 American College of Rheumatology classification criteria in the diagnosis of vasculitis. Ann Intern Med 1998, 129:345–352.

    PubMed  CAS  Google Scholar 

  18. Sorensen SF, Slot O, Tvede N, Petersen J: A prospective study of vasculitis patients collected in a five year period: evaluation of the Chapel Hill nomenclature. Ann Rheum Dis 2004, 59:478–482.

    Article  Google Scholar 

  19. Davies DJ, Moran JE, Niall JF, Ryan GB: Segmental necrotising glomerulonephritis with antineutrophil antibody: possible arbovirus aetiology? Br Med J 1982, 285:606.

    Article  CAS  Google Scholar 

  20. van der Woude FJ, Rasmussen N, Lobatto S, et al.: Autoantibodies against neutrophils and monocytes: tool for diagnosis and marker of disease activity in Wegener’s granulomatosis. Lancet 1985, 1:425–429.

    PubMed  Google Scholar 

  21. Savige J, Gillis D, Benson E, et al.: International consensus statement on testing and reporting of antineutrophil cytoplasmic antibodies. Am J Clin Pathol 1999, 111:507–513.

    PubMed  CAS  Google Scholar 

  22. Hagen EC, Daha MR, Hermans J, et al.: Diagnostic value of standardized assays for anti-neutrophil cytoplasmic antibodies in idiopathic systemic vasculitis. EC/BCR Project for ANCA Assay Standardization. Kidney Int 1998, 53:743–753.

    Article  PubMed  CAS  Google Scholar 

  23. Wiik A: Anti-neutrophil cytoplasmic antibodies tests: which tests should be used in practice? Intern Med 2001, 40:466–470.

    PubMed  CAS  Google Scholar 

  24. Schonermarck U, Lamprecht P, Csernok E, Gross WL: Prevalence and spectrum of rheumatic diseases associated with proteinase 3-antineutrophil cytoplasmic antibodies (ANCA) and myeloperoxidase-ANCA. Rheumatology 2001, 40:178–184.

    Article  PubMed  CAS  Google Scholar 

  25. Hunder GG, Arend WP, Bloch DA, et al.: The American College of Rheumatology 1990 criteria for the classification of vasculitis. Introduction. Arthritis Rheum 1990, 33:1065–1067.

    Article  PubMed  CAS  Google Scholar 

  26. Fries JF, Hunder GG, Bloch DA, et al.: The American College of Rheumatology 1990 criteria for the classification of vasculitis. Summary. Arthritis Rheum 1990, 33:1135–1136.

    Article  PubMed  CAS  Google Scholar 

  27. Jennette JC, Falk RJ, Andrassy K, et al.: Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum 1994, 37:187–192.

    Article  PubMed  CAS  Google Scholar 

  28. Cotch MF: The socioeconomic impact of vasculitis. Curr Opin Rheumatol 2000, 12:20–23.

    Article  PubMed  CAS  Google Scholar 

  29. Jayne D: Update on the European vasculitis study group trials. Curr Opin Rheumatol 2001, 13:48–55.

    Article  PubMed  CAS  Google Scholar 

  30. Gross WL, Trabandt A, Reinhold-Keller E: Vasculitis: aims of therapy/Guest Editor: R. Watts. Diagnosis and evaluation of vasculitis. Rheumatology 2000, 39:245–252.

    Article  PubMed  CAS  Google Scholar 

  31. Bruce IN, Bell AL: A comparison of two nomenclature systems for primary systemic vasculitis. BJR 1997, 36:453–458.

    Article  CAS  Google Scholar 

  32. Watts RA, Jolliffe VA, Carruthers DM, et al.: Effect of classification on the incidence of polyarteritis nodosa and microscopic polyangiitis. Arthritis Rheum 1996, 39:1208–1212.

    Article  PubMed  CAS  Google Scholar 

  33. Jennette JC, Falk RJ: Diagnostic classification of antineutrophil cytoplasmic autoantibody-associated vasculitides. Am J Kidney Dis 1991, 18:184–187.

    PubMed  CAS  Google Scholar 

  34. Stone JH, Talor M, Stebbing J, et al.: Test characteristics of immunofluorescence and ELISA tests in 856 consecutive patients with possible ANCA-associated conditions. Arthritis Care Res 2000, 13:424–434.

    Article  PubMed  CAS  Google Scholar 

  35. Hoffman GS: Classification of the systemic vasculitides: antineutrophil cytoplasmic antibodies, consensus and controversy. Clin Exp Rheumatol 1998, 16:111–115. This is a comprehensive editorial about the limitations vasculitides classifications share, as well as the role ANCA have in the diagnosis and in the pathogenesis of these disorders.

    PubMed  CAS  Google Scholar 

  36. Falk RJ, Jennette JC: ANCA are pathogenic—oh yes they are!. J Am Soc Nephrol 2002, 13:1740–1749.

    Article  CAS  Google Scholar 

  37. Seo P, Stone JH: The antineutrophil cytoplasmic antibodyassociated vasculitides. Am J Med 2004, 17:39–50.

    Article  CAS  Google Scholar 

  38. Lane SE, Watts RA, Barker THW, Scott DGI: Evaluation of the Sorensen diagnostic criteria in the classification of systemic vasculitis. Rheumatology 2002, 41:1138–1141.

    Article  PubMed  CAS  Google Scholar 

  39. Neer CS, Watson KC, Stanton FJ: Recent experience in total shoulder replacement. J Bone Joint Surg 1982, 64-A:319–337.

    Google Scholar 

  40. Hunder GG: The use and misuse of classification and diagnostic criteria for complex diseases. Ann Intern Med 1998, 129:417–418.

    PubMed  CAS  Google Scholar 

  41. Angeli E, Vanzulli A, Venturini M, et al.: The role of radiology in the diagnosis and management of Takayasu’s arteritis. J Nephrol 2001, 14:514–524.

    PubMed  CAS  Google Scholar 

  42. Buckley A, Southwood T, Culham G, et al.: The role of ultrasound in evaluation of Takayasu’s arteritis. J Rheumatol 1991, 18:1073–1080.

    PubMed  CAS  Google Scholar 

  43. Matsunaga N, Hayashi K, Sakamoto I, et al.: Takayasu arteritis: MR manifestations and diagnosis of acute and chronic phase. J Magn Reson Imaging 1998, 8:406–414.

    Article  PubMed  CAS  Google Scholar 

  44. Luqmani RA, Bacon PA, Moots RJ, et al.: Birmingham vasculitis activity score (BVAS) in systemic necrotizing vasculitis. Q J Med 1994, 87:671–678.

    CAS  Google Scholar 

  45. Whiting-O’Keefe QE, Stone JH, Hellmann DB: Validity of a vasculitis activity index for systemic necrotizing vasculitis. Arthritis Rheum 1999, 42:2365–2371.

    Article  PubMed  CAS  Google Scholar 

  46. Exley AR, Bacon PA, Luqmani RA, et al.: Development and initial validation of the Vasculitis Damage Index for the standardized clinical assessment of damage in the systemic vasculitides. Arthritis Rheum 1997, 40:371–380.

    Article  PubMed  CAS  Google Scholar 

  47. Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992, 31:247–263.

    Google Scholar 

  48. Abu-Shakra M, Smythe H, Lewtas J, et al.: Outcome of polyarteritis nodosa and Churg-Strauss syndrome. An analysis of twenty-five patients. Arthritis Rheum 1994, 37:1798–1803.

    Article  PubMed  CAS  Google Scholar 

  49. Furukawa S, Matsubara T, Yone K, et al.: Kawasaki disease differs from anaphylactoid purpura and measles with regard to tumour necrosis factor-alpha and interleukin 6 in serum. Eur J Pediatr 1992, 151:44–47.

    Article  PubMed  CAS  Google Scholar 

  50. Adam B, Calikoglu E: Serum interleukin-6, procalcitonin and C-reactive protein levels in subjects with active Behcet’s disease. J Eur Acad Dermatol Venereol 2004, 18:318–320.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bertoli, A.M., Alarcón, G.S. Classification of the vasculitides: Are they clinically useful?. Curr Rheumatol Rep 7, 265–269 (2005). https://doi.org/10.1007/s11926-005-0035-6

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11926-005-0035-6

Keywords

Navigation