Vasculitides
| Description | Direct clinical signs: Episcleritis (“red eye”), acute hearing loss, vertigo, hemoptysis, microhematuria, mono-, polyneuritis, palpable purpura, angina pectoris, bloody diarrhea, infarctions (heart, kidney, brain), dissecting aneurysm, venous thrombosis. Indirect signs: Fever, adynamia, night sweat, polymyalgia, -arthralgia, -myositis, CRP-increase, leukocytosis, anemia. Basic evaluations: CRP, blood count, complement C3, C4, creatinine, urine status, urine protein-SDS-electrophoresis Immunology: cANCA, pANCA, ANA, anti-ds-dna, ENA, cryoglobulines, immune electrophoresis, cardiolipin-antibodies, glomerular basal membrane antibodies Infection serology: Hepatitis B and C, CMV, herpes simplex, measles, coxsackie, lues, rickettsia (Q-fever) Blood cultures: Please note: Biopsy evaluation is usually pointing in the right direction.
Wegener’s granulomatosis: cANCA (proteinase 3-antibodies, 70-80 %), urine status/sediment, if necessary pANCA (myeloperoxidase-antibodies) Microscopic polyarteritis: pANCA (myeloperoxidase-antibodies, 60-100 %), cANCA (up to 10 %), urine status/sediment, urine protein-SDS-electrophoresis Kawasaki-syndrome: No specific laboratory diagnostics, if necessary cANCA, endothelium antibodies Takayasu’s-arteritis: No specific laboratory diagnostics, CRP, ESR, endothelium antibodies, anemia
Polyarteritis nodosa: No specific laboratory diagnostics, if necessary immune complexes, cANCA, hepatitis B serology, urine status/sediment, creatinine, blood count (eosinophilia), amylase, pancreas-elastase Allergic granulomatous arteritis (Churg-Strauss-Syndrome): No specific laboratory diagnostics, however very apparent eosinophilia (> 1000/µl in 80 % of all patients), pANCA (10-20 %), cANCA (10-20 %), total IgE (↑) Hypersensitivity vasculitis: No specific laboratory diagnostics, if necessary cryoglobulines, rheumatoid factor, C4 Purpura Schönlein-Henoch: C4, immune complexes (frozen serum), cryoglobulines, IgA
Temporal arteritis (giant cell arteritis): No specific laboratory diagnostics, CRP, ESR (usually 50-100 mm/1 hour), anemia, ANA, CK, SGOT, SGPT, AP Rheumatoid polymyalgia: No specific laboratory diagnostics, CRP, ESR (usually 50-100 mm/1 hour), anemia, ANA, CK, SGOT, SGPT, AP
In case of known underlying illnesses such as rheumatoid arthritis, SLE, infections, tumors or medication-associated |