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Vasculitis - Coggle Diagram

- - - - Sudden onset almost perment vision loss
  - - - Tender
      - Swollen
      - Thickened
      - Nodular
      - Reduced ./ absent pulse
      - Temporal muscle wastin
    - - In GCA focally tender over occipital notch - artery inflammation in area
    - - .1 Aortic - check there is no murmur first
      - Carotid
      - Subclavian
      - Axiallary - under upper arm not axilla
  - - - Taper dose
      - Lots of s/e
        Population already have risk factors for s/e eg Older, female
      - Complications
        
        Fracture
        
        Sepsis
        
        Diabetes
        
        Cataracts
        
        Infection
      - Adjuncts
        
        PPI
        
        Bisphosphonate ( or denosumab but rarely used)
        
        +/- Calcium / Vit D
    - - More s/e effects
        Shingles
        Cancer
  - - - Steroid + Tocilizumb
    - - Add Tocilizumab
    - - Upadacitinib
    - - Upadacitnib pro c/i too
      - Steroid monotherapy
- - - - Fever
      - Weight loss
      - Anorexia
      - Malaise
    - - Nasal crusting
      - Nose bleeds
      - Sinusitis
      - Epistaxis
      - Saddle nose
      - Otitis media
      - Subglottic stenosis
      - Nasal erythemia
    - - Recurrent inf
      - HAemoptysis
      - Pulmonary nodules / infiltrates
      - Haemorrhage
    - - Active urinary sediment
      - Haematuria > Proteinuria
      - REd cell casts
      - Pauci immune appearance
        Contrast with lupus
      - AKI- late consequence of renal involvement
    - - Scleritis
      - Proptosis - lumps of nodules of GPA behind eyes
      - Episcleriis
    - - Leucocytoclastic> ?? vasculitis
      - Purpura / ulceration
      - Arthralgia / arthritis
      - Myositis
      - Mononeuritis multiplex
  - - - Renal>Lungs>>>>>>>>>>>>>>>>>nasal / skin
  - - - Severe disease
        
        +/- avacopan
        
        steroid replacing
        
        AND
        
        Rituximab ( or cyclophosphamide - )
        
        Glucocortoids
      - Milder disease
        
        Glucocorticoids + MXT or azathioprin or MMF
        
        Or rituximab?
    - - Methylprednisolon 1g Od IV x3/7
        Then
      - Trial PEXIVAS ?
- - - - Steroids
      - Non-glucocorticoid
        MTX / Lef / MMF
        TNFi or IL6i
    - - VEry high risk
        
        Procedural complicaation
        
        Restenosis
      - Indications
        
        Critical disease of neck
        
        Refractory HTN / renal failure
        
        CArdiac ischaemic
        
        Critical organ damage
        
        Qol/Function
- - - - Incidence 17/ 100,000 relatively common in ireland
      - 3:1 female
      - Northern europe
      - Cranial arteries
      - .>50 years
    - - .<40 years
      - Incidence 1 / million
      - (:1 female
      - Asia
      - Aorta and branches