Vasculitis: From Diagnosis to Treatment

290 Pages·2022·9.772 MB·English

by  Roger M. Brown

RHEUMATISM AND MUSCULOSKELETAL DISORDERS

V
ASCULITIS

F D T
ROM IAGNOSIS TO REATMENT

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R
HEUMATISM AND
M D
USCULOSKELETAL ISORDERS
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RHEUMATISM AND MUSCULOSKELETAL DISORDERS

V
ASCULITIS

F D T
ROM IAGNOSIS TO REATMENT

ROGER M. BROWN
EDITOR
Copyright © 2021 by Nova Science Publishers, Inc.
DOI: https://doi.org/10.52305/DLVW4660
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CONTENTS

Preface vii
Chapter 1 Giant Cell Arteritis 1
Harsha Pattnaik, Nicky N. Chopra,
Adrian A. Jarquin-Valdivia, Rahul Kashyap
and Salim Surani
Chapter 2 Pulmonary Complications of Vasculitis 43
Pahnwat Tonya Taweesedt, Julian Bayati,
Farah Yasmin, Munish Sharma and Salim Surani
Chapter 3 Eosinophilic Granulomatosis with Polyangiitis 89
N. Vobugari, Kejal Gandhi, K. Raja,
Farah Yasmin, Iqbal Ratnani and Salim Surani
Chapter 4 Cardiovascular Complications of Vasculitis 125
Syed Adeel Hassan, Somia Jamal Sheikh,
Iqbal Ratnani and Salim Surani
Chapter 5 Cerebral Vasculitides Associated with Central
Nervous System Herpesviridae Infection 155
Tracey Fan, Alise Carlson, Ahmad Mahadeen
and Richard A. Prayson
vi Contents
Chapter 6 Gastrointestinal Complications of Vasculitis 179
The Dang, Luis O. Chavez, Monica Leon,
Kejal Gandhi, Pahnwat Taweesedt
and Salim Surani
Chapter 7 Hypocomplementic Urticarial
Vasculitis Syndrome 199
Kejal Gandhi, N. Vobugari and Salim Surani
Chapter 8 Pulmonary Capillaritis in
Systemic Lupus Erythematosus 221
Chrong-Reen Wang, Wei-Chieh Lin
and Ming-Fei Liu
Chapter 9 Cerebral Venous Sinus Thrombosis
as a Complication of COVID-19 Vaccination 245
N. Prasad, Salim Surani and Rahul Kashyap
Index 263
PREFACE

Vasculitis refers to diseases that cause blood vessel walls to thicken
and narrow, cutting off blood supply to tissues and organs. Vasculitis
encapsulates several conditions, and the cause of vasculitis is often
unknown. This book explores various forms of vasculitis and options for
treatment. Chapter one includes a detailed description of giant cell arteritis,
a form of vasculitis involving inflammation of the middle and large
arteries, including the latest management strategies. Chapter two concerns
different types of vasculitis affecting the lungs, their signs and symptoms,
treatment, and complications needed for diagnosis. Chapter three deals
with eosinophilic granulomatosis with polyangiitis, a multisystemic
necrotizing vasculitis characterized by allergic rhinitis, asthma, and
peripheral eosinophilia. Chapter four describes the common
pathophysiology and cardiovascular complications arising in different
vasculidities. Chapter five reviews the pathophysiology, epidemiology,
diagnostic investigation, and treatment of infection etiologies of
Herpesviridae associated with vasculitis. Chapter six elucidates the impact
of vasculitis on the gastrointestinal system. Chapter seven explains
hypocomplementic urticarial vasculitis syndrome, defined as presence of
greater than six months of urticaria along with hypocomplementemia and
multi-system manifestations such as recurrent abdominal pain, uveitis,
arthralgia and glomerulonephritis. Chapter eight explicates the use of
viii Roger M. Brown
biologics in treating rheumatology disorders, with rituximab being
recommended in organ-threatening, refractory systemic lupus
erythematosus. Lastly, chapter nine discusses the pathophysiology and
adverse effects of adenoviral vector vaccinations for SARS-CoV-2 and the
importance of identifying the true epidemiology of adverse outcomes
regarding promoting increased acceptance of COVID-19 vaccinations,
while stressing that despite the possibility of adverse outcomes, the
benefits of vaccination outweigh the risks of remaining unvaccinated.
Chapter 1 - Giant Cell Arteritis (GCA) is the inflammation of middle
and large arteries commonly affecting the elderly with a female
preponderance. In this chapter, the authors have included a detailed
description and the latest management. Its diagnosis is muddled by a
constellation of vague manifestations like fever, headache, anemia, high
ESR, which may or may not include the characteristic symptoms due to
ophthalmic arteritis and polymyalgia rheumatica. On temporal artery
biopsy, which remains the gold standard of diagnosis, patchy pan-arteritis,
with focal granulomatous lesions and giant cells, is seen. Recently,
ultrasonography (USG), MRI, and PET scans are being adopted to
optimize the diagnostic process. Corticosteroids remain the mainstay of
treatment and are crucial in retarding the disease process to prevent
blindness. Though methotrexate and various immunosuppressants have
been tried as adjuncts with arguable results, Tocilizumab has been
approved for use in the treatment of GCA. Abatacept and Ustekinumab are
promising new candidates. GCA is an evolving field in terms of diagnosis
and new biological therapies.
Chapter 2 - Vasculitis is an inflammation of the blood vessel. Patients
with connective tissue disease can have a vascular injury which can be
primary or secondary. The primary vasculitis is the inflammation of the
blood vessel, whereas the secondary vasculitis is caused by secondary
condition as connective tissue disease, infection, malignancy or allergy.
Primary vasculitis is defined based on the size of the affected vessel. It can
be large vessel vasculitis as Takayasu arteritis, medium vessel vasculitis as
polyarteritis nodosa, and small-vessel vasculitis which predominantly
affects small vessels. Pulmonary vasculitis is a rare condition with an