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vasculitides guidelines

B Hellmich
The results of a number of prospective randomized controlled clinical trials have led to changes in established strategies for the treatment of antineutrophil cytoplasmic antibody (ANCA) associated vasculitides (AAV) in recent years. Since 2014, a total of 4 scientific societies and study groups have systematically reviewed the new data and have formulated evidence-based recommendations for the management of AAV based on the analysis. These recommendations contain information on diagnosis, treatment (induction and maintenance), supportive care and monitoring of disease activity and resulting damage...
November 15, 2016: Zeitschrift Für Rheumatologie
Giuseppe Lopalco, Donato Rigante, Vincenzo Venerito, Giacomo Emmi, Maria Grazia Anelli, Giovanni Lapadula, Florenzo Iannone, Luca Cantarini
Inflammation mediated by cells of the immune system and necrosis are the most striking features observed at the histologic level in patients with vasculitides, clinical entities classified according to pathologic findings involving different organs, to etiology, or to size of vessels involved. Small vessel vasculitides (SVV) are a peculiar group of systemic disorders electively involving small intraparenchymal arteries, arterioles, capillaries, or venules and leading to different levels of vascular obstruction, tissue ischemia and risk of infarction; they can be divided into anti-neutrophil cytoplasmic antibody-associated vasculitides and immune complex vasculitides...
June 2016: Current Rheumatology Reports
Manabu Fujimoto, Yoshihide Asano, Takayuki Ishii, Fumihide Ogawa, Tamihiro Kawakami, Masanari Kodera, Masatoshi Abe, Taiki Isei, Takaaki Ito, Yuji Inoue, Shinichi Imafuku, Ryokichi Irisawa, Masaki Ohtsuka, Mikio Ohtsuka, Takafumi Kadono, Masakazu Kawaguchi, Ryuichi Kukino, Takeshi Kono, Keisuke Sakai, Masakazu Takahara, Miki Tanioka, Takeshi Nakanishi, Yasuhiro Nakamura, Akira Hashimoto, Minoru Hasegawa, Masahiro Hayashi, Hiroshi Fujiwara, Takeo Maekawa, Koma Matsuo, Naoki Madokoro, Osamu Yamasaki, Yuichiro Yoshino, Andres Le Pavoux, Takao Tachibana, Hironobu Ihn
The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS)...
July 2016: Journal of Dermatology
Jiri Vymetal, Martina Skacelova, Andrea Smrzova, Anna Klicova, Marketa Schubertova, Pavel Horak, Josef Zadrazil
BACKGROUND AND AIM: Rheumatic diseases are commonly considered chronic conditions. However, acute manifestations can be very severe and represent a diagnostic problem. Examples are systemic lupus erythematosus with acute flare, glomerulonephritis, CNS disorders and catastrophic antiphospholipid syndrome, scleroderma with interstitial lung disease, pulmonary hypertension and renal crisis and polyangiitis with alveolar haemorhage and acute respiratory failure. This aim of this paper is to overview emergency situations which can be encountered in the care of patients with autoimmune systemic diseases and vasculitides...
March 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
J B Kümmerle-Deschner, J Thomas, S M Benseler
BACKGROUND: The primary vasculitides are rare conditions in childhood. The most common disease subtypes are Schönlein-Henoch purpura and Kawasaki's syndrome, which frequently have a self-limiting course. In the majority of vasculitides, the etiology remains unknown. Environmental exposure, including infections, is suspected to trigger an autoinflammatory response in predisposed individuals. GOAL: The aim of this review is to present the various aspects of childhood vasculitis...
December 2015: Zeitschrift Für Rheumatologie
Lucy McGeoch, Marinka Twilt, Leilani Famorca, Volodko Bakowsky, Lillian Barra, Susan Benseler, David A Cabral, Simon Carette, Gerald P Cox, Navjot Dhindsa, Christine Dipchand, Aurore Fifi-Mah, Michele Goulet, Nader Khalidi, Majed M Khraishi, Patrick Liang, Nataliya Milman, Christian A Pineau, Heather Reich, Nooshin Samadi, Kam Shojania, Regina Taylor-Gjevre, Tanveer E Towheed, Judith Trudeau, Michael Walsh, Elaine Yacyshyn, Christian Pagnoux
The Canadian Vasculitis research network (CanVasc) is composed of physicians from different medical specialties, including rheumatology and nephrology and researchers with expertise in vasculitis. One of its aims was to develop recommendations for the diagnosis and management of antineutrophil cytoplasm antibody (ANCA)-associated vasculitides in Canada. This executive summary features the 19 recommendations and 17 statements addressing general AAV diagnosis and management, developed by CanVasc group based on a synthesis of existing international guidelines, other published supporting evidence and expert consensus considering the Canadian healthcare context...
2015: Canadian Journal of Kidney Health and Disease
Kenan Barut, Sezgin Sahin, Ozgur Kasapcopur
PURPOSE OF REVIEW: The aim of this review is to define childhood vasculitis and to highlight new causative factors and treatment modalities under the guidance of recently published studies. RECENT FINDINGS: Childhood vasculitis is difficult to diagnose because of the wide variation in the symptoms and signs. New nomenclature and classification criteria were proposed for the diagnosis of pediatric vasculitis. Recently, progress has been made toward understanding the genetic susceptibility to pediatric vasculitis as it was in other diseases...
January 2016: Current Opinion in Rheumatology
Lucy McGeoch, Marinka Twilt, Leilani Famorca, Volodko Bakowsky, Lillian Barra, Susan M Benseler, David A Cabral, Simon Carette, Gerald P Cox, Navjot Dhindsa, Christine S Dipchand, Aurore Fifi-Mah, Michelle Goulet, Nader Khalidi, Majed M Khraishi, Patrick Liang, Nataliya Milman, Christian A Pineau, Heather N Reich, Nooshin Samadi, Kam Shojania, Regina Taylor-Gjevre, Tanveer E Towheed, Judith Trudeau, Michael Walsh, Elaine Yacyshyn, Christian Pagnoux
OBJECTIVE: The Canadian Vasculitis research network (CanVasc) is composed of physicians from different medical specialties and researchers with expertise in vasculitis. One of its aims is to develop recommendations for the diagnosis and management of antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV) in Canada. METHODS: Diagnostic and therapeutic questions were developed based on the results of a national needs assessment survey. A systematic review of existing non-Canadian recommendations and guidelines for the diagnosis and management of AAV and studies of AAV published after the 2009 European League Against Rheumatism/European Vasculitis Society recommendations (publication date: January 2009) until November 2014 was performed in the Medline database, Cochrane library, and main vasculitis conference proceedings...
January 2016: Journal of Rheumatology
N P Shilkina
A new nomenclature of systemic vasculitides (SV) and current approaches to their treatment have necessitated the discussion of some debatable questions on this condition. The paper gives the data of examining 325 patients with different forms of SV, followed up in the Interregional Consulting Center for SV patients, and the results of testing the American College of Rheumatology classification criteria for SV and the authors' criteria, by taking into account the International Chapel Hill Consensus Conference, USA (1994 and 2011) guidelines for CV nomenclature...
2015: Terapevticheskiĭ Arkhiv
Elena Csernok, Julia U Holle
Wegener's granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome, and primary pauci-immune crescentic glomerulonephritis are associated with circulating antineutrophil cytoplasmic autoantibodies (ANCA) (collectively called ANCA-associated vasculitides, AAV). Two types of ANCA, one with a cytoplasmic fluorescence pattern (C-ANCA) and specificity for proteinase 3 (PR3-ANCA) and the other with a perinuclear pattern (P-ANCA) and specificity for myeloperoxidase (MPO-ANCA), account for this association and are highly specific markers for these vasculitides...
May 2010: Auto- Immunity Highlights
H J Leu, A J Leu
Phlebosclerosis, phlebothrombosis, and thrombophlebitis are three fundamentally different structural changes affecting superficial, deep, visceral, and cerebral veins. Phlebosclerosis is a frequent, age-dependent fibrotic degeneration of one or all three wall layers. It does not represent a distinct disease entity but may impair the venous function and contribute to the development of thrombosis. Phlebothrombosis represents a serious circulatory disorder. It may be due to a variety of factors including phlebitis, i...
July 1996: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
U Müller-Ladner, K Richter, I H Tarner
The term modern disease-modifying antirheumatic drugs (DMARD) includes not only the constantly growing family of DMARDs for chronic inflammatory rheumatic diseases but also the repositioning of established drugs in updated and novel algorithms of the different entities. The usual precursor for these developments is rheumatoid arthritis for which completely revised and updated guidelines have been published not only in Germany but also on the European level. In addition, label extensions to existing drugs have been granted for connective tissue diseases and vasculitides, e...
March 2015: Der Internist
Abdel Rahman A Al Emam, Ahmed Almomani, Syed A Gilani
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. It occurs predominantly among younger females and typically in the absence of atherosclerotic coronary artery disease. It is associated with peripartum period, connective tissue disorders, vasculitides, and extreme exertion. Presentations vary greatly, and this condition can be fatal. Given its rarity, there are no guidelines for management of SCAD. We present the cases of two female patients, with no coronary artery disease risk factors or recent pregnancy, who were presented with non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI), respectively, secondary to SCAD...
December 2014: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Ben Mulhearn, Ian N Bruce
The use of IVIG to treat a wide variety of immune-driven diseases has grown rapidly, although the mechanism of action is not completely understood. Increasing demand for IVIG coupled with concerns regarding potential transmissible agents has led to worldwide supply shortages. National agencies have therefore produced guidelines for its use, with the latest England and Wales guideline being published in 2011. Due to the rarity of the rheumatic diseases, the evidence for IVIG use has been shown to be lacking in some areas and promising in others...
March 2015: Rheumatology
Kresimir Galesić, Ivica Horvatić
ANCA-associated vasculitides are a well-known clinico-pathological group of systemic diseases comprising microscopic poliangiitis, granulomatosis with poliangiitis and eosinophilic granulomatosis with poliangiitis. This article shows contemporary treatment of this diseases with extensive literature review. Stepwise treatment of ANCA-associated vasculitides is divided into induction therapy and remission maintenance therapy. Standard induction therapy is a combination of glucocorticoids and cyclophosphamide, and in maintenance therapy, combination of low-dose glucocorticoids and azathioprine or methotrexate is used...
July 2014: Lijec̆nic̆ki Vjesnik
Anne Vital, Claude Vital
Simultaneous combined superficial peroneal nerve and peroneous brevis muscle biopsy, via the same cutaneous incision, allows examination of several tissue specimens and significantly improves the diagnosis of systemic diseases with peripheral nerve involvement. Vasculitides are certainly the most frequently diagnosed on neuro-muscular biopsies, but this procedure is also well advised to asses a diagnosis of sarcoidosis or amyloidosis. More occasionally, combined nerve and muscle biopsy may reveal an unpredicted diagnosis of cholesterol embolism, intra-vascular lymphoma, or enables complementary diagnosis investigations on mitochondrial cytopathy or storage disease...
May 2014: Clinical Neuropathology
Vincent Goëb, Marc Ardizzone, Laurent Arnaud, Jérôme Avouac, Athan Baillet, Alexandre Belot, Béatrice Bouvard, Pascal Coquerelle, Sabrina Dadoun, Alain Diguet, David Launay, Danielle Lebouc, Pierre Loulergue, Sophie Mahy, Pascal Mestat, Gaël Mouterde, Benjamin Terrier, Coralie Varoquier, Mathieu Verdet, Xavier Puéchal, Jean Sibilia
The use of TNFα antagonists must follow specific guidelines to ensure optimal effectiveness and safety. The French Society for Rheumatology (SFR) and Task Force on Inflammatory Joint Diseases (CRI), in partnership with several French learned societies, asked the French National Authority for Health (HAS) to develop and endorse good practice guidelines for the prescription and monitoring of TNFα antagonist therapy by physicians belonging to various specialties. These guidelines were developed, then, validated by two multidisciplinary panels of experts based on an exhaustive review of the recent literature and in compliance with the methodological rules set forth by the HAS...
December 2013: Joint, Bone, Spine: Revue du Rhumatisme
Pierre Charles, Boris Bienvenu, Bernard Bonnotte, Pierre Gobert, Pascal Godmer, Éric Hachulla, Mohamed Hamidou, Jean-Robert Harlé, Alexandre Karras, Jean-Christophe Lega, Alain Le Quellec, Alfred D Mahr, Luc Mouthon, Thomas Papo, Xavier Puéchal, Gregory Pugnet, Maxime Samson, Jean Sibilia, Benjamin Terrier, Frederick Vandergheynst, Loïc Guillevin
Increasing rituximab prescription for ANCA-associated necrotizing vasculitides justifies the publication of recommendations for clinicians. Rituximab is approved in the United States to induce and maintain remission. In Europe, rituximab was recently approved for remission induction. However, governmental agencies' approvals cannot replace clinical practice guidelines. Herein, the French Vasculitis Study Group Recommendations Committee, comprised of physicians with extensive experience in the treatment of vasculitides, presents its consensus guidelines based on literature analysis, the results of prospective therapeutic trials and personal experience...
October 2013: La Presse Médicale
Janneke Tuin, Jan-Stephan F Sanders, Birgit M Buhl, André P van Beek, Coen A Stegeman
INTRODUCTION: Low testosterone levels in men are associated with fatigue, limited physical performance and reduced health-related quality of life (HRQOL); however, this relationship has never been assessed in patients with anti-neutrophil cytoplasmic antibodies (ANCA) -associated vasculitides (AAV). The aim of this study was to assess the prevalence of androgen deficiency and to investigate the role of testosterone in fatigue, limited physical condition and reduced HRQOL in men with AAV...
2013: Arthritis Research & Therapy
Anthea Craven, Joanna Robson, Cristina Ponte, Peter C Grayson, Ravi Suppiah, Andrew Judge, Richard Watts, Peter A Merkel, Raashid A Luqmani
The systemic vasculitides are a group of uncommon diseases characterized by blood vessel inflammation. There are currently no diagnostic criteria for the primary systemic vasculitides and physicians must rely on experience and disease definitions. The absence of validated criteria can result in delays in making the correct diagnosis and starting appropriate therapy. With the increased understanding of the pathophysiology of vasculitis and newer diagnostic tests in widespread clinical use, it is an appropriate time for classification criteria for primary vasculitis to be revised...
October 2013: Clinical and Experimental Nephrology
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