S8C14VA5-Angiitides (VA)

Vasculitis

(Conn, et al)

Group I: visceral involvement (sparing of lungs)

Group II: lungs, plus other viscera

a. Wegener granulomatosis

b. Churg-Strauss vasculitis

Group III: limited vasculitis (skin, joints, and peripheral nerves)

S8C14VA5-1: Categories of vasculitis as related to anatomic distribution are listed.

Vasculitis

(Group I)

1. rheumatoid factor (5/16)

2. hypocomplementemia (7/16)

3. hepatitis B antigen (2/16)

4. immune complexes (3/16)

S8C14VA5-2: Correlations between anatomic group I (S8C14VA5-1) and laboratory findings are listed.

Vasculitis (Group II)

(Churg-Strauss)

1. asthma (initial complaint)

2. vasculitis of lungs and viscera

3. eosinophilia

4. elevated IgE (also noted in Wegener granulomatosis)

S8C14VA5-3: Features of some group II lesions are listed.

Granulomatous Angiitis

(perivascular granulomas; Group II - including Wegener’s granulomatosis)

1. fibrinoid necrosis of vessel, and perivascular granulomas

2. perivascular allergic granulomas

3. insoluble complexes (Ag-Ab at equivalance or antibody excess)

S8C14VA5-4: Some group II lesions also may be characterized by granulomatous angiitis or perivascular granulomas.

Coagulopathies

1. Shwartzman reaction (as a model)

a. preparatory dose (endotoxin)

b. provoking dose (non-specific)

S8C14VA5-5: Thrombosis of vessels is common in the vasculitic disorders and, in some examples, the coagulation of blood is the primary alteration; such disorders might be characterized as coagulopathies. In some examples, the alterations in the viscosity of the blood relate to the presence of abnormal substances, or abnormal amounts of normal substances. The Shwartzman reaction is a model for the study of the effects of thrombotic occlusion of vessels.

Coagulopathies

1. Shwartzman reaction (as a model)

a. natural antibody?

b. localized or generalized

c. renal cortical necrosis (classic type)

d. intravascular fibrin thrombi

S8C14VA5-6: Features of the Shwartzman reaction are listed.

Thrombotic Angiitides

(Examples)

1. amniotic fluid embolism

2. malaria

3. livedo vasculitis

4. coagulopathies

5. Buerger’s disease

6. Degos’ disease (malignant atrophic papulosis)

7. chemical (topical) angiitis - 5FU

8. angiodermatitis (stasis)

9. marantic thrombi

S8C14VA5-7: Some disorders, in which thrombosis of vessels is an important factor, are listed.

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