Internal Medicine

0521779407-08 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:11

Granulomatous Vasculitis 647

Granulomatous Vasculitis..............................

ERIC L. MATTESON, MD

history & physical

Wegener’s Granulomatosis (WG)

■Constitutional symptoms

■“Prolonged sinus infection” w/ oral-nasal bloody discharge

■Male:female 1:1

Signs & Symptoms

■Sinusitis, cough; nasal or oral ulcerations (90%)

■Hemoptysis, pleuritis, lower airways disease (85%)

■Arthritis (65%)

■Vasculitic skin lesions (45%)

■Peripheral or central neuropathy (25%)

■Peripheral edema (renal disease)(65%)

■Proptosis, eye pain (50%)

Giant Cell Arteritis (GCA)

■Age always >50 yrs

■Female:male 2:1

■Assoc w/ polymyalgia rheumatica

■Affects the aorta & branches, including temporal artery

Signs & Symptoms

■New-onset headache, often unilateral (80%)

■Jaw claudication (40%)

■Visual changes or loss (20%)

■TIAs or stroke (5%)

■Fever, systemic symptoms (30%)

■Polymyalgia rheumatica (40%)

■Tender temporal artery (50%)

Takayasu Arteritis (TA)

■Female:male 10:1; <40 yrs of age

Signs & Symptoms

■Dizziness, syncope, upper or lower extremity

■Claudication

■Vascular bruits & pulse deficits

■Hypertension more common than in GCA