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Vasculitiden

Thijs Wingelaar
by

Thijs Wingelaar

on 18 February 2014

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Transcript of Vasculitiden

Vasculitiden
Pathofysiologie
Immuungemedieerde ontsteking
en necrose bloedvaten (systemisch)

Immuuncomplex
Humoraal
Cellulair
Onbekend
Jenette JC, Falk RJ. Small-vessel vasculitis.
New Engl J Med (1997) 337: 1512-1523
Large Vessel Vasculitis
Arteriitis temporalis
m. Takayasu
> 50 jr
< 50 jr
Medium-sized Vessel Vasculitis
Polyarteriitis nodosa



m. Kawasaki
mononeuritis, abdominale viscera, nierfalen, hartfalen, livedo reticularis

< 5 jr, 5 dagen koorts
Symptomen
Men moet altijd bedacht zijn op vasculitis bij;
- onverklaarde koorts,
- algemene malaise,
- vermagering,
- mononeuritis multiplex,
- myositis,
- nefritis,
- onverklaarde artritis,
- afwijkingen van meer organen of
orgaansystemen bij RA of SLE.
Labuitslagen
Reumafactoren
Anti-Nuclear Antibodies
dsDNA
AntiNeutrophil Cytoplasmic Antibodies
c-ANCA [PR3], p-ANCA [MPO]
Cryoglobulinen
HBsAg
Complementverbruik
Circulerende immuuncomplexen
Small Vessel Vasculitis
Wegener
Churg-Strauss
Mircoscopische
polyangiitis

Henoch-Schönlein
ANCA +, long en nier
ANCA +, long, zenuw en huid
ANCA +, nier


ANCA -, huid, spieren
Therapie
Geen behandeling (alleen huid)

Immunosuppresiva
corticosteroïden
cyclofosfamide
azathioprine
Bronnen
Pathologic Basis of Disease: 534 - 543

Clinical Medicine: 581 - 586, 938, 1355

Interne Geneeskunde: 793 - 796

Up-to-date
Full transcript