SMALL Wegener’s URT + LRT + cANCA 90% Immunosuppsn. granulomatosis glomerulonephritis Microscopic Glomerulonephritis, 90% polyangitis purpura, haemoptysis Churg-Strauss Allergic rhinitis, Eosinophilia, High dose pred asthma, sinusitis, c/pANCA 40% eosinophilia More detail: Wegener’s granulomatosis Rare. —Presentation: Tired, lethargic, fever, purpuric rash, arthralgia. —Systemic: —Triad: symptoms: Epistaxis, nasal septum destruction, rhinorrhoea, laryngeal —URT damage. symptoms: Haemoptysis, cough, fibrosis, SOB. —LRT Haematuria, proteinuria, HTn. —Glomerulonephritis: positive in 90%. —Ix: High dose immunosuppressants e.g. corticosteroids, cyclophosphamide. —Tx: Churg-Strauss. Allergic granulomatosis. Middle aged: —Presentation: rhinitis, asthma. —Allergic disease: eosinophilic pneumonia, gastrenteritis, Eosinophilia >10% peripheral —Eosinophilic blood. vasculitis: nerves, GIT. —Systemic p and cANCA +ve in 40% —Ix: High dose prednisolone —Tx: nodosa, Necrotizing vasculitis -> aneurysms and thrombosis medium sized arteries. —Polyarteritis Young-middle aged men —Presentation: unwell —Systemically haemorrhagic rash, punched out ulcers —Skin: aneurysms (75%, main cause of death). Also haematuria, proteinuria and HTn. —Renal Immunosuppression —Tx: Kawasaki disease Child, protracted fever over 5 days - acute systemic febrile vasculitis + 4 of: —Presentation:
SMALL Wegener’s granulomatosis URT + LRT + glomerulonephritis cANCA 90% Immunosuppsn. Microscopic polyangitis Glomerulonephritis, purpura, haemoptysis 90% Churg-Strauss Allergic rhinitis, asthma, sinusitis, eosinophilia Eosinophilia, c/pANCA 40% High dose pred More detail: Wegener’s granulomatosis —Presentation: Rare. —Systemic: Tired, lethargic, fever, purpuric rash, arthralgia. —Triad: —URT symptoms: Epistaxis, nasal septum destruction, rhinorrhoea, laryngeal damage. —LRT symptoms: Haemoptysis, cough, fibrosis, SOB. —Glomerulonephritis: Haematuria, proteinuria, HTn. —Ix: positive in 90%. —Tx: High dose immunosuppressants e.g. corticosteroids, cyclophosphamide. Churg-Strauss. Allergic granulomatosis. —Presentation: Middle aged: —Allergic rhinitis, asthma. —Eosinophilic disease: eosinophilic pneumonia, gastrenteritis, Eosinophilia >10% peripheral blood. —Systemic vasculitis: nerves, GIT. —Ix: p and cANCA +ve in 40% —Tx: High dose prednisolone —Polyarteritis nodosa, Necrotizing vasculitis -> aneurysms and thrombosis medium sized arteries. —Presentation: Young-middle aged men —Systemically unwell —Skin: haemorrhagic rash, punched out ulcers —Renal aneurysms (75%, main cause of death). Also haematuria, proteinuria and HTn. —Tx: Immunosuppression Kawasaki disease —Presentation: Child, protracted fever over 5 days - acute systemic febrile vasculitis + 4 of: