Symptoms of vasculitis
How does vasculitis typically present?
There is no single typical presentation of vasculitis. Vasculitis should be suspected in any constitutionally ill patient who has evidence of multisystem inflammatory disease. The clinical manifestations may suggest the size of vessel involved and the most likely vasculitis. Typical presentations are as follows:
- • Large-vessel vasculitis: limb claudication, bruits, asymmetric blood pressures, absence of pulses, thoracic aortic aneurysm. Temporal headache, jaw claudication, or blindness if extracranial branches of carotid artery involved.
- • Medium-vessel vasculitis: cutaneous nodules, ulcers, livedo reticularis, digital gangrene, mononeuritis multiplex, renovascular hypertension, and organ infarct.
- • Small-vessel vasculitis: palpable purpura, urticaria, glomerulonephritis, alveolar hemorrhage, and scleritis.
Pearl : Headache or visual loss in the elderly (GCA), asymmetric pulses with bruits in a patient aged <30 years (Takayasu arteritis), mononeuritis multiplex (PAN), rapidly progressive pulmonary–renal syndrome (ANCA-associated vasculitis), and palpable purpura (immune complex-mediated vasculitis) are the most common presentations suggesting vasculitis. Patients with systemic vasculitis feel poorly and frequently experience low-grade fever, fatigue, and weight loss.
