vasculitis

Vasculitis - an inflammation of the blood vessel wall. The origin of vasculitis may be primary (idiopathic) or secondary. Primary vasculitis are independent nosological forms; they are characterized by widespread lesions of arterial and venous vascular departments, as well as microcirculation. Secondary vasculitis are seen as manifestations of other diseases - infectious (eg, typhus), autoimmunity (such as rheumatoid arthritis, systemic lupus erythematosus, etc.), And other tumor.

Systemic vasculitis are a group of rheumatic diseases and include polyarteritis nodosa , thromboangiitis obliterans, Wegener's granulomatosis, a non-specific, aortoarteriit, temporal arteritis, a hemorrhagic vasculitis and some rare forms.

The etiology of systemic vasculitis remains unclear. In some patients the disease occurs after hypothermia, bacterial and viral infections, administration of serums, vaccines, drug use and the effects of other exogenous factors.

The mechanism of development of vasculitis leading role for the immune system, immediate hypersensitivity reactions and delayed types (see. Allergy), which leads to increased fracture permeability and vascular wall cells with subsequent deformation and sclerosis. Disturbed blood coagulation system. Reduced blood flow to various organs and tissues.

Clinically characterized by systemic vasculitis, or multiple lesions of many organs, tissues and vascular beds. The clinical picture depends primarily on the nosology and the caliber of the affected vessels, but a number of the symptoms most characteristic of systemic vasculitis: fever ; cutaneous manifestations in the form of a marble figure, cyanosis of extremities, rashes of various character (papular, nodular, hemorrhagic), trophic disorders; muscle pain, cramps at rest; polyarthralgia, mono- and polyarthritis; signs of polyneuritis. Characteristically consecutive defeat various internal organs. Involvement of the coronary arteries of the heart is manifested by pain such as angina, occurrence in some cases, myocardial infarction, heart muscle lesions with the development of myocarditis and subsequent myocardiosclerosis. Changes in lung blood vessels leading to the development of pneumonia, bronchospastic syndrome, pulmonary infarction, pulmonary fibrosis, pulmonary hypertension and the formation of pulmonary heart. There ulcerative lesions of the gastrointestinal tract, the intestinal wall infarction, bleeding, enlarged liver and spleen, the phenomenon of acute and chronic pancreatitis, thrombosis, mesenteric vessels, followed by gangrene of the bowel wall. Renal disease is characterized by the development of jade with the changes in the urine in the form of proteinuria, hematuria, increased blood pressure, nephrotic syndrome. The involvement of the nervous system leads to the development of polyneuritis, cerebrovascular events. If it affects the limbs marked intermittent claudication, Raynaud's phenomenon and migratory phlebitis .

The majority of patients when a blood test revealed violations, indicating the presence of inflammation: increased erythrocyte sedimentation rate, fibrinogen level, the content of A2-globulin, C-reactive protein, but specific changes in systemic vasculitis absent.

Current systemic vasculitis often prolonged, relapsing. The prognosis for many forms remains poor, although the use of modern regimens can increase the life expectancy of patients, and in some cases to maintain the ability to work.