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BMC Cardiovascular Disorders Jan 2021Cardiac vasculitis is recognized as a heterogeneous disease process with a wide spectrum of manifestations including pericarditis, myocarditis, valvular heart disease... (Review)
Review
Cardiac vasculitis is recognized as a heterogeneous disease process with a wide spectrum of manifestations including pericarditis, myocarditis, valvular heart disease and less frequently, coronary artery vasculitis (CAV). CAV encompasses an emerging field of diseases which differ from conventional atherosclerotic disease and have a proclivity for the younger population groups. CAV portends multiple complications including the development of coronary artery aneurysms, coronary stenotic lesions, and thrombosis, all which may result in acute coronary syndromes. There are several aetiologies for CAV; with Kawasaki's disease, Takayasu's arteritis, Polyarteritis Nodosa, and Giant-Cell Arteritis more frequently described clinically, and in literature. There is a growing role for multi-modality imaging in assisting the diagnostic process; including transthoracic echocardiography, cardiac magnetic resonance imaging, computed tomography coronary angiography, fluorodeoxyglucose-positron emission tomography and conventional coronary angiogram with intravascular ultrasound. Whilst the treatment paradigms fundamentally vary between different aetiologies, there are overlaps with pharmacological regimes in immunosuppressive agents and anti-platelet therapies. Interventional and surgical management are is a consideration in select populations groups, within a multi-disciplinary context. Further large-scale studies are required to better appropriately outline management protocols in this niche population.
Topics: Cardiac Imaging Techniques; Coronary Artery Disease; Giant Cell Arteritis; Humans; Mucocutaneous Lymph Node Syndrome; Multimodal Imaging; Polyarteritis Nodosa; Predictive Value of Tests; Prognosis; Takayasu Arteritis
PubMed: 33407141
DOI: 10.1186/s12872-020-01813-6 -
Arteriosclerosis, Thrombosis, and... Aug 2019Vasculitis is a systemic disease characterized by immune-mediated injury of blood vessels. Current treatments for vasculitis, such as glucocorticoids and alkylating... (Review)
Review
Vasculitis is a systemic disease characterized by immune-mediated injury of blood vessels. Current treatments for vasculitis, such as glucocorticoids and alkylating agents, are associated with significant side effects. Furthermore, the management of both small and large vessel vasculitis is challenging because of a lack of robust markers of disease activity. Recent research has advanced our understanding of the pathogenesis of both small and large vessel vasculitis, and this has led to the development of novel biologic therapies capable of targeting key cytokine and cellular effectors of the inflammatory cascade. In parallel, a diverse range of imaging modalities with the potential to monitor vessel inflammation are emerging. Continued expansion of combined structural and molecular imaging using positron emission tomography with computed tomography or magnetic resonance imaging may soon provide reliable longitudinal tracking of vascular inflammation. In addition, the emergence of radiotracers able to assess macrophage activation and immune checkpoint activity represents an exciting new frontier in imaging vascular inflammation. In the near future, these advances will allow more precise imaging of disease activity enabling clinicians to offer more targeted and individualized patient management.
Topics: Eosinophils; Humans; Lymphocyte Depletion; Magnetic Resonance Imaging; Molecular Imaging; Polyarteritis Nodosa; Positron-Emission Tomography; Systemic Vasculitis; Tomography, X-Ray Computed
PubMed: 31189432
DOI: 10.1161/ATVBAHA.118.310957 -
Proceedings of the Royal Society of... Nov 1949
Topics: Humans; Polyarteritis Nodosa
PubMed: 15394808
DOI: No ID Found -
Proceedings of the Royal Society of... Nov 1956
Topics: Cortisone; Polyarteritis Nodosa
PubMed: 13379441
DOI: No ID Found -
Anais Brasileiros de Dermatologia 2015Polyarteritis nodosa is a rare vasculitis in children characterized by necrotizing inflammation in small and medium size arteries. It is classified into systemic and...
Polyarteritis nodosa is a rare vasculitis in children characterized by necrotizing inflammation in small and medium size arteries. It is classified into systemic and cutaneous PAN according to the presence of systemic symptoms or visceral involvement. We describe the case of a 14-year-old girl with cutaneous Polyarteritis nodosa with an atypical clinical presentation.
Topics: Adolescent; Biopsy; Female; Humans; Necrosis; Polyarteritis Nodosa; Skin; Subcutaneous Fat
PubMed: 26312712
DOI: 10.1590/abd1806-4841.20153856 -
California Medicine May 1951The collagen diseases have in common certain relatively specific alterations in the tissues that are derived from the mesenchyme.In reviewing the development of this...
The collagen diseases have in common certain relatively specific alterations in the tissues that are derived from the mesenchyme.In reviewing the development of this concept, the nature and the pathogenesis of these changes and the blocking effect of cortisone and ACTH are discussed. The term "diseases of the collagen system" includes a number of clinical states within a broad spectrum of variation in the basic alterations of collagenous and vascular tissues. In rheumatoid arthritis the modifications are chiefly in the somatic connective tissue; in periarteritis nodosa the blood vessel involvement is preeminent; dermatomyositis and disseminated lupus erythematosus present more intermediate mixtures of these changes.
Topics: Adrenocorticotropic Hormone; Arthritis, Rheumatoid; Collagen; Collagen Diseases; Cortisone; Dermatomyositis; Humans; Lupus Erythematosus, Systemic; Polyarteritis Nodosa
PubMed: 14848691
DOI: No ID Found -
Proceedings of the Royal Society of... Oct 1960
Topics: Humans; Medical Records; Polyarteritis Nodosa
PubMed: 13705270
DOI: No ID Found -
Clinical Immunology (Orlando, Fla.) Jun 2020Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that predominantly affects medium-sized arteries. With the establishment and refinement of vasculitis... (Review)
Review
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that predominantly affects medium-sized arteries. With the establishment and refinement of vasculitis nomenclature and diagnostic criteria, clinical findings of PAN and distinguishing features from other vasculitides are now well characterized. Although PAN typically manifests in adulthood, cohort studies in paediatric patients have shaped our understanding of childhood-onset PAN. The paradigm of childhood-onset PAN changed considerably with the landmark discovery of deficiency of ADA2 (DADA2), a monogenic cause of vasculitis that is often indistinguishable from PAN. Testing for DADA2 has provided an explanation to numerous challenging cases of familial PAN and early-onset PAN around the world. The ability to distinguish DADA2 from classic PAN have important therapeutic implications as tumor necrosis factor inhibitors have demonstrated remarkable efficacy in the treatment of DADA2. In this review, we will discuss our current understanding of PAN and DADA2 and highlight similarities and differences between these vasculitides.
Topics: Adenosine Deaminase; Humans; Polyarteritis Nodosa; Tumor Necrosis Factor-alpha
PubMed: 32276138
DOI: 10.1016/j.clim.2020.108411 -
Hypertension Research : Official... Jul 1999We sought to clarify the incidence, vessel-size and age distribution of periarteritis nodosa in rats occurring as a vascular lesion in malignant hypertension....
We sought to clarify the incidence, vessel-size and age distribution of periarteritis nodosa in rats occurring as a vascular lesion in malignant hypertension. Stroke-prone spontaneously hypertensive and stroke-resistant spontaneously hypertensive rat strains were studied, as well as Wistar-Kyoto control rats. Mesenteric arteries and testicular arteries were examined histologically. Additionally, electron microscopy investigation was carried out on one stroke-prone hypertensive rat and one control. Periarteritis nodosa lesions were present in testicular arterioles in 57.1%, and mesenteric arteries in 28.6%, of stroke-prone hypertensive rats aged 9.5 mo. Lesion incidence at these sites was 100% and 60% respectively in 10 stroke-prone rats aged 15.5 mo, and 42.9% and 28.6% in stroke-resistant hypertensive rats aged 22.5 mo. In contrast, the incidence rate was 0% at both sites in stroke-resistant hypertensive rats aged 8 or 14.5 mo, and in control rats aged 9.5 or 25 mo. In stroke-prone rats, arteritis lesion counts (mean+/-SD) in testicular sections were 11.6+/-17 at age 9.5 mo and 96.3+/-60.9 at age 15.5 mo. In individual lesion scoring, arteritis was more severe in mesenteric arteries than in testicular arterioles. For arteriolar lesion distribution patterns in testicular sections, partial peripheral, partial peripheral plus central, and circumferential patterns were all noted. In conclusion, periarteritis nodosa in hypertensive stroke-prone rats occurs earlier in testicular arterioles, but attains greater severity in the mesenteric artery.
Topics: Animals; Arterioles; Body Weight; Hypertension; Male; Mesenteric Arteries; Microscopy, Electron; Polyarteritis Nodosa; Rats; Rats, Inbred SHR; Rats, Inbred WKY; Testis
PubMed: 10487326
DOI: 10.1291/hypres.22.105 -
Journal of Clinical Pathology Apr 2001The manifestations of human immunodeficiency virus (HIV) infection are protean and vasculitides are one of the less common but nonetheless important consequences. A wide... (Review)
Review
The manifestations of human immunodeficiency virus (HIV) infection are protean and vasculitides are one of the less common but nonetheless important consequences. A wide range of vasculitides can be encountered, ranging from vasculitis resulting from specific infective agents to a non-specific vasculitis. Among the infective causes, cytomegalovirus and tuberculosis are probably the most common. A polyarteritis nodosa-like vasculitis with important differences to classic polyarteritis nodosa is also described. Hypersensitivity vasculitis resulting in several patterns of vasculitis and angiocentric immunoproliferative vasculitis are well recognised. As part of the immunocompromise caused by HIV, a granulomatous inflammation involving small arteries and veins of the brain surface and leptomeninges, termed a primary angiitis of the central nervous system, is a rare vasculitis associated with high mortality. A recently described large vessel (aorta, femorals, carotids) vasculopathy resulting in either multiple aneurysm formation or occlusive disease is seen in young adults. An infective agent is not found but aetiologically some of these lesions might be the result of a leucocytoclastic vasculitis of vasa vasora or periadventitial vessels. A final group of non-specific vasculitides not fitting into any of the characteristic patterns described accounts for the residue of vasculitides associated with HIV.
Topics: Central Nervous System Diseases; HIV Infections; Humans; Necrosis; Polyarteritis Nodosa; Vasculitis
PubMed: 11304843
DOI: 10.1136/jcp.54.4.275