systemic vasculitis
Introduction
Introduction Systemic Vasculitis is a group of inflammatory diseases characterized by inflammation and necrosis of blood vessels. The clinical manifestations vary according to the type, size, location and pathological characteristics of the affected vessels. It often involves multiple systems throughout the body, causing multiple system and multiple organ dysfunction, but it can also be limited to a certain organ. The most common sites of systemic vasculitis are the skin, kidneys, lungs, and nervous system. The clinical manifestations of this group of diseases are complex and varied, and many of them are intractable.
Cause
Cause
Most of the causes are too difficult and unclear. A few causes are more clear last year, such as serum drug countless drug allergies and infection with hepatitis B virus. It has been confirmed that it is a comparative cause of various vasculitis, and then found cytomegalovirus, herpes simplex virus, adult T cells. Leukemia virus can cause vasculitis.
Examine
an examination
Related inspection
Angiographic blood routine immunoglobulin assay for anti-neutrophil cytoplasmic radial artery biopsy
1. White blood cell count and classification are mostly mild to moderately elevated
There are often positive cells and positive pigmented anemia of chronic diseases. Urine sediment can have a red blood cell cast. ESR can be elevated during the active period of Wegener's granulomatosis and giant cell arteritis.
2. Immunoglobulins often have a polyclonal increase
RF positive is more common in juvenile vasculitis patients and 50% in Wegener granulomatosis. The deposition of immune complexes (ICs) in affected tissues and elevated circulating immune complexes (CIC) contribute to diagnosis.
Cold globulin
Its existence is diagnostic. High levels of cryoglobulin suggest that plasmapheresis should be treated, and the presence of cryoglobulin monoclonal immunoglobulin suggests potential tumors.
4. Anti-neutrophil cytoplasmic antibody (ANCA)
It is divided into two types: cytoplasmic type (c-ANCA) and perinuclear type (p-ANCA). ANCA is associated with systemic vasculitis, especially Wegener's granulomatosis and microscopic polyarteritis, with positive rates of 90% (c-ANCA-based) and 70% (p-ANCA-based).
5. Angiography
It is an important diagnostic tool to help understand the location, extent, extent of vascular involvement, impact on the body, and prognosis.
6. Biopsy
The diagnosis of most vasculitis requires this result. It is advisable to use an open type, and the puncture often does not take the lesion.
Systemic vasculitis should be suspected of unexplained fever and multiple system involvement, especially kidney involvement, ischemic symptoms, palpable ecchymoses, and single or multiple neuritis.
Diagnosis
Differential diagnosis
Inflammation should be identified in different parts of the lungs: diffuse, interstitial or nodular lesions may occur, which may include cough, shortness of breath, and difficulty breathing.
Kidney: Hematuria, proteinuria, high incidence, often early renal dysfunction.
Liver: Hepatic discomfort and liver damage.
Cardiovascular: There is no pulse, and the difference in blood pressure between the two limbs increases.
Nervous system: due to intracranial blood supply vascular disease, causing symptoms of cerebral ischemia, intracranial vasculitis can cause intracranial hemorrhage or nodular lesions. The supply of peripheral vascular lesions can cause neuropathy and neurological sensation and dyskinesia.
Nasopharyngeal: In Wegener's granulomatosis (one of vasculitis), there may be granulomatous lesions of the nasopharynx, nasal congestion, nosebleeds and other symptoms.
Skin: Many vasculitis can cause rash, skin vascular changes, and sometimes rash is the only clinical manifestation. In allergic purpura, there may be skin bleeding spots and bleeding spots. Some manifest as nodular lesions, which appear after mosquito bites, and are found in allergic vasculitis and Behcet's disease. In addition, there are joint pains, gastrointestinal symptoms and the like.
