The Enigma of Vasculitis

Abstract

We describe the case of an 86-year-old man presenting with clinical symptoms suggestive of Temporal Arteritis. The evolution of the case prompted extensive work-up, including temporal artery and kidney biopsy. Based on the clinical and pathological findings, a diagnosis of ANCA-negative granulomatous necrotizing vasculitis involving the small-, medium-, and large-size vessels was made. The patient was treated with prednisone and cyclophosphamide, which was later switched to rituximab. The patient remained asymptomatic under this regimen and stabilization of his kidney function was achieved.

Isolated lower limb medium-vessel vasculitis: a new entity?

“…Early treatment of vasculitis minimises disease associated damage,1 the most common treatments involve steroids and cytotoxic medications. During treatment, careful monitoring for disease remission and drug-induced toxicity are fundamental and guide treatment 10.…”

“…This unique presentation of a vasculitis has the potential to cause a delay in diagnosis and therefore a delay in treatment. Given that delays in treatment can lead to irreversible damage of the organ or limbs affected,1 our case highlights the importance of considering vasculitidies even when autoimmune investigations are negative. Furthermore, to the best of our knowledge, isolated lower limb ANCA-negative medium-vessel vasculitidies are rarely reported in literature.…”

Caso clínico 02-2018. Mujer 76 años con cefalea, dolor articular y disfagia de rápida instauración

“…199 sural, ayuda a confirmar que la patogenia corresponde a una vasculitis necrotizante, al parecer primaria, pues en el trabajo diagnóstico no se encontró infección, neoplasia o una causa de pseudovasculitis; siempre es posible el desarrollo de vasculitis de vasos de menor calibre en las vasculitis. Culminaremos mencionando que aún hoy las vasculitis constituyen un enigma (29).…”