Journal
EUROPEAN JOURNAL OF INTERNAL MEDICINE
Volume 74, Issue -, Pages 18-28Publisher
ELSEVIER
DOI: 10.1016/j.ejim.2020.01.011
Keywords
Autoimmune diseases; Anti-neutrophil cytoplasmic antibody-associated vasculitis; Granulomatosis with polyangiitis; Churg-Strauss syndrome; Microscopic polyangiitis
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Vasculitis is characterized by inflammation of the vascular wall. It reaches vessels of different sizes and locations, conditioning multisystem and complex manifestations that require a holistic approach. Antineutrophil cytoplasmic antibody-associated vasculitis has an annual incidence rate of 20 per million inhabitants. It is the result of the interaction of infectious, genetic and environmental factors and manifest itself with varied and unspecific symptoms, often reaching the general state, respiratory and renal systems. The combination of clinical, laboratory, imaging and fundamentally histological changes allows the diagnosis and classification of the extent / severity of the disease necessary for the decision of the therapeutics to be taken. Glucocorticoids are generally used; with methotrexate being considered when localized disease and cyclophosphamide, rituximab or azathioprine when generalized disease. A systematized approach can increase survival rates from 12% to 70% over a 5-year span.
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