Summary
Definition
History and exam
Key diagnostic factors
- constitutional symptoms (e.g., malaise, fever, arthralgia, myalgia)
- headache and scalp tenderness (giant cell arteritis)
- visual changes (large-vessel)
- upper extremity or jaw claudication (large-vessel)
- asymmetric brachial pulses (large-vessel)
- bruits (large-vessel)
- abdominal pain (medium-vessel)
- foot drop, wrist drop (medium-vessel)
- cutaneous ulcers (medium-vessel)
- hematuria (small-vessel)
- palpable purpura (small-vessel)
- otorrhea, ear pain, or muffled sensation in the ears (small-vessel)
- nasal symptoms (small-vessel)
- sinus pain (small-vessel)
- wheeze (small-vessel)
- hemoptysis (small-vessel)
Diagnostic investigations
1st investigations to order
- erythrocyte sedimentation rate (ESR)
- C-reactive protein (CRP)
- antineutrophil cytoplasmic auto-antibodies (ANCA)
- blood urea nitrogen and serum creatinine
- urinalysis
- biopsy of affected tissue
Investigations to consider
- conventional angiography or magnetic resonance angiography (MRA)
- positron emission tomography (PET) scan
Treatment algorithm
Contributors
Authors VIEW ALL
Associate Professor of Medicine
Director, Fellowship Program
Division of Rheumatology
Johns Hopkins University School of Medicine
Director
The Johns Hopkins Vasculitis Center
Baltimore
MD
Disclosures
PS declares that he has no competing interests.
Peer reviewers VIEW ALL
Assistant Professor of Medicine
Division of Rheumatology and Immunology
Duke University
Durham
NC
Disclosures
MC declares that she has no competing interests.
Consultant Rheumatologist
Department of Rheumatology
Freeman Hospital
Newcastle Upon Tyne
UK
Disclosures
BG declares that she has no competing interests.
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