A patient with a small vessel vasculitis can be furthered classified based on clinical and laboratory findings.
Patient selection: vasculitis involving small blood vessels
Parameters:
(1) serum positive for ANCA
(2) granulomatous inflammation in the vasculitis
(3) asthma and eosinophilia
(4) IgA-rich immune deposits on immunofluorescence
(5) serum cryoglobulin
|
ANCA |
Granuloma |
Asthma and Eosinophils |
IgA rich Immune Deposits |
Serum Cryo-globulins |
Diagnosis |
|
positive |
present |
present |
NA |
NA |
CSS |
|
positive |
present |
negative |
NA |
NA |
WG |
|
positive |
absent |
NA |
NA |
NA |
mPA, DIV |
|
negative |
NA |
NA |
present |
NA |
HSP |
|
negative |
NA |
NA |
negative |
positive |
CG |
|
negative |
NA |
NA |
negative |
negative |
ANSVV |
where:
• CSS = Churg-Strauss syndrome; WG = Wegener's granulomatosis; mPA = microscopic polyangiitis; DIV = drug-induced vasculitis; HSP = Henoch-Schonlein purpura; CG = cryoglobulinemia
• ANSVV = ANCA-negative small vessel vasculitis, which may include ANCA-negative microscopic polyangiitis, PAN involving small blood vessels; Wegener's granulomatosis with rare granulomas; drug-induced vasculitis, paraneoplastic small blood vessel vasculitis, etc.
• Drug-induced vasculitis is not shown in Figure 2 but is discussed on page 1619.
• Some patients with microscopic polyangiitis may have asthmatic symptoms.
Purpose: To evaluate a patient with a small vessel vasculitis.
Specialty: Immunology/Rheumatology
Objective: laboratory tests, other testing, criteria for diagnosis
ICD-10: M05.2,
