When should the rheumatologist suspect vasculitis mimics?
Because of its protean manifestations, vasculitis can easily be confused with other diseases. Mimics of vasculitis must be excluded early in the evaluation because treatment varies dramatically and misdiagnosis may result in morbidity and/or mortality. Vasculitis mimics should be suspected when there is:
- a) A new heart murmur (subacute bacterial endocarditis [SBE]).
- b) Necrosis of lower-extremity digits (cholesterol emboli).
- c) Splinter hemorrhages (SBE).
- d) Prominent liver dysfunction (hepatitis C).
- e) Drug abuse (HIV; hepatitis B/C; cocaine, etc.).
- f) Prior diagnosis of neoplastic disease.
- g) Unusually high fever (SBE).
- h) History of high-risk sexual activity (HIV).
- i) History of herpes zoster or varicella infection (cerebral vasculopathy).
- j) New medication recently prescribed.
