Systemiske vaskulitter
Sist revidert:
Sist revidert av:Terje Johannessen
Definisjon:
En heterogen gruppe forstyrrelser der det foreligger inflammasjon og skade på blodåreveggene, noe som fører til vevsnekrose
Forekomst:
Sjeldne tilstander med en rapportert årlig insidens på 40-54 tilfeller per 1 million innbyggere
Symptomer:
Tilstanden kan være begrenset til hud eller andre organer, eller det kan være en multisystem tilstand med multiple manifestasjoner
Funn:
Varierer avhengig av størrelse, sted og utbredelse av involverte kar
Diagnostikk:
Tilleggsundersøkelser er full blodstatus, akutt fase reaktanter, nyrefunksjon, leverfunksjon, ANCA, rtg thorax, andre bildeundersøkelser, histologi
Behandling:
Induksjon av remisjon gjøres med steroider og methotrexat eller cyklofosfamid
- Nasjonal kompetansetjeneste for svangerskap og revmatiske sykdommer (NKSR) - nettside
- Sharma P, Sharma S, Baltaro R, Hurley J. Systemic vasculitis. Am Fam Physician 2011; 83: 556-65. American Family Physician
- Merkel PA. Overview of the management of vasculitis in adults. UpToDate, last updated Mar 30, 2021. UpToDate
- Reinhold-Keller E, Herlyn K, Wagner-Bastmeyer R, Gross WL. Stable incidence of primary systemic vasculitides over five years: results from the German vasculitis register. Arthritis Rheum 2005; 53: 93-9. PubMed
- Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013; 65:1. PubMed
- Basu N, Watts R, Bajema I, et al. EULAR points to consider in the development of classification and diagnostic criteria in systemic vasculitis. Ann Rheum Dis 2010; 69: 1744-50. PubMed
- Kim ESH, Beckman J. Takayasu arteritis: challenges in diagnosis and management. Heart 2017. doi:10.1136/heartjnl-2016-310848 DOI
- Danila MI, Bridges SL Jr. Update on pathogenic mechanisms of systemic necrotizing vasculitis. Curr Rheumatol Rep 2008; 10: 430-35. PubMed
- Roggenbuck D, Buettner T, Hoffmann L, Schmechta H, Reinhold D, Conrad K. High-sensitivity detection of autoantibodies against proteinase-3 by a novel third-generation enzyme-linked immunosorbent assay. Ann N Y Acad Sci 2009; 1173: 41-6. PubMed
- Savige J, Pollock W, Trevisin M. What do antineutrophil cytoplasmic antibodies (ANCA) tell us? Best Pract Res Clin Rheumatol 2005; 19: 263-76. PubMed
- Hogan SL, Falk RJ, Chin H, et al. Predictors of relapse and treatment resistance in antineutrophil cytoplasmic antibody-associated small-vessel vasculitis. Ann Intern Med 2005; 143: 621-31. Annals of Internal Medicine
- Pagnoux C, Hogan SL, Chin H, et al. Predictors of treatment resistance and relapse in antineutrophil cytoplasmic antibody-associated small-vessel vasculitis: comparison of two independent cohorts. �Arthritis Rheum 2008; 58: 2908-18.
- Baer AZ, Rubin LG, Shapiro CA, et al. Prevalence of coronary artery lesions on the initial echocardiogram in Kawasaki syndrome. Arch Pediatr Adolesc Med 2006; 160: 686-90. PubMed
- Espinola-Zavaleta N, Soto ME, Bauk L, et al. Coronary reserve in Takayasu's arteritis: transesophageal echocardiographic analysis. Echocardiography 2005; 22: 593-8. PubMed
- Bourgarit A, Le Toumelin P, Pagnoux C, Cohen P, Mahr A, Le Guern V, Mouthon L, Guillevin L. Deaths occurring during the first year after treatment onset for polyarteritis nodosa, microscopic polyangiitis, and Churg-Strauss syndrome: a retrospective analysis of causes and factors predictive of mortality based on 595 patients. Medicine (Baltimore) 2005; 84: 323-30. PubMed
- Merkel PA. Overview of the management of vasculitis in adults. UpToDate, last updated Aug 12, 2019. UpToDate
- Loïc Guillevin, Christian Pagnoux, Alexandre Karras, et al. Rituximab versus Azathioprine for Maintenance in ANCA-Associated Vasculitis. NJEM 2014; 371: 1771-80. doi:10.1056/NEJMoa1404231 DOI
- Stone JH, Merkel PA, Spiera R et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med 2010; 363: 221-32. New England Journal of Medicine
- Jones RB, Tervaert JW, Hauser T. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med 2010; 363: 211-20. New England Journal of Medicine
- Wegener's Granulomatosis Etanercept Trial (WGET) Research Group. Etanercept plus standard therapy for Wegener's granulomatosis. N Engl J Med 2005; 352: 351-61. New England Journal of Medicine
- Walsh M, Floßmann O, Berden A, Westman K, Höglund P, Stegeman C, Jayne D. Risk factors for relapse of ANCA associated vasculitis. Arthritis Rheum Sep 27 2011 (Epub ahead of prin) ; : .
- Langford CA. Drug insight: anti-tumor necrosis factor therapies for the vasculitic diseases. Nat Clin Pract Rheumatol 2008; 4: 364-70. PubMed
- Eleftheriou D, Melo M, Marks SD, et al. Biologic therapy in primary systemic vasculitis of the young. Rheumatology (Oxford) 2009; 48: 978-86. PubMed
- Furuta S, Nakagomi D, Kobayashi Y, et al. Effect of Reduced-Dose vs High-Dose Glucocorticoids Added to Rituximab on Remission Induction in ANCA-Associated Vasculitis A Randomized Clinical Trial. JAMA 2021; 325: 2178-87. pmid:34061144 PubMed
- Mukhtyar C, Guillevin L, Cid MC, et al. EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis 2009; 68: 318-23. PubMed
- Heijl C, Harper L, Flossmann O, Stücker I, Scott DG, Watts RA, Höglund P, Westman K, Mahr A. Incidence of malignancy in patients treated for antineutrophil cytoplasm antibody-associated vasculitis: follow-up data from European Vasculitis Study Group clinical trials. Ann Rheum Dis 2011; 70: 1415-21. PubMed
- Pagnoux C, Chironi G, Simon A, Guillevin L. Atherosclerosis in ANCA-associated vasculitides. Ann N Y Acad Sci 2007; 1107: 11-21. PubMed
- Nasjonal kompetansetjeneste for svangerskap og revmatiske sykdommer (NKSR). Nasjonal veileder for svangerskap og revmatiske sykdommer. Trondheim; sist oppdatert mars 2018, siden besøkt 09.12.19
- Terje Johannessen, professor i allmennmedisin, Trondheim
Tidligere fagmedarbeidere
- Wenche Koldingsnes, overlege, Revmatologisk avdeling, UNN