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Large-vessel vasculitis

by: Hanyao Foong

Large-vessel vasculitis 1001

Hanyao Foong
Leonard M. Miller School of Medicine

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About this Document

Summary of the two main large-vessel vasculitis in the clinical settings
Study Guide
rheumatology; infection; vasculitis
50 ?




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This 0 page Study Guide was uploaded by Hanyao Foong on Sunday January 3, 2016. The Study Guide belongs to 1001 at Leonard M. Miller School of Medicine taught by in Winter2015. Since its upload, it has received 44 views. For similar materials see Medcine in Military Science at Leonard M. Miller School of Medicine.

Similar to 1001 at Leonard M. Miller School of Medicine

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Date Created: 01/03/16
Largevessel Vasculitis Features Giant cell arteritis GCATemporal arteritis Predominantly affects branches of temporal and ophthalmic arteries Elderly females 70 years old Raised ESR Onset of symptoms may be abrupt but often insidious over course of several weeks or months Headache usually the rst symptom Unilateral localised to temporal or occipital region scalp tenderness eg When combing hair Jaw claudication chewing or talking due to ischemia of the masseters Visual disturbance sudden blindness typically in one eye amaurosis fugax Associated with polymyalgia rheumatica PMR in 50 gt PMR bilateral muscle pain and stiffness in proximal limb muscles and shoulders gt Increased ESR gt Treat with Prednisolone Expect dramatic response within 1 week and if not it is not PMR Risk irreversible bilateral visual loss If suspect GCA do ESR and start Prednisolone immediately Get temporal artery biopsy within 7 days of starting steroids skip lesions occur negative biopsy does not exclude diagnosis Takayasu s arteritis aortic arch syndrome pulseless disease Granulomatous in ammation and thickening of vessels causing stenosis thrombosis aneurysms Affects aorta and its proximal vessels Often women 2040 years old most common in Asia Symptoms depends on arteries involved gt Aortic arch often affected cerebral opthalmological and upper limb symptoms gt Dizziness visual changes weak arm pulses gt Systemic symptoms common fever arthralgia weight loss gt Raised BP due to renal artery stenosis Complications gt Aortic valve regurgitation gt Aortic aneurysm and dissection gt lschaemic stroke increased BP and thrombus gt lschaemic heart disease Diagnosis gt High ESR and CRP gt MRIPET allows earlier diagnosis than standard angiography Treatment Prednisolone BP control is essential to decrease risk of stroke Prognosis 95 survival at 15 years


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