Vasculitis/Inflammatory Vascular Diseases/Necrotising vasculitis(polyarteritis nodosa)
Uncommon, heterogeneous group of conditions characterised by immune mediated inflammation of blood vessels, often with fibrinoid necrosis impairs circulation – may involve one or many organ systems. Clinical features will vary depending on site and size of the involved vessels. Most common clinical presentation is a palpable purpura (non-blanchable, raised redness/erythema) – indicates extravasation of red blood cells. Most have musculoskeletal manifestations, but they are often overshadowed by involvement of other organ systems. Terminology in literature can be confusing and classification is difficult.
Vasculitis inflammation of arteries, veins and capillaries
Arteritis inflammation of arteries and arterioles
Chapel Hill classification:
1) Large vessel – Takayasu’s arteritis, giant cell arteritis (aortitis also occurs in seronegative spondyloarthropathy, relapsing polychondritis, Behcet’s disease)
2) Medium vessel – polyarteritis nodosa, Kawasaki’s disease
3) Small vessel – Churg-Strauss vasculitis, Wegener’s granulomatosis, Hypersensitivity vasculitis, microscopic polyangiitis, Henoch-Schonlein purpura, essential cryoglobulinaemia vasculitis, leukocytoclastic angiitis
Disease activity can be measured using the Birmingham Vasculitis Activity Score and/or the Vasculitis Damage Index .