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Small vessel vasculitis

MedGen UID:
868710
Concept ID:
C4023113
Disease or Syndrome
SNOMED CT: Small vessel vasculitis (724599009)
 
HPO: HP:0011944

Definition

A type of vasculitis (inflammation of blood vessel walls) that affects blood vessels that are smaller than arteries, i.e., arterioles, venules, and capilllaries. [from HPO]

Term Hierarchy

Conditions with this feature

Wiskott-Aldrich syndrome
MedGen UID:
21921
Concept ID:
C0043194
Disease or Syndrome
The WAS-related disorders, which include Wiskott-Aldrich syndrome, X-linked thrombocytopenia (XLT), and X-linked congenital neutropenia (XLN), are a spectrum of disorders of hematopoietic cells, with predominant defects of platelets and lymphocytes caused by pathogenic variants in WAS. WAS-related disorders usually present in infancy. Affected males have thrombocytopenia with intermittent mucosal bleeding, bloody diarrhea, and intermittent or chronic petechiae and purpura; eczema; and recurrent bacterial and viral infections, particularly of the ear. At least 40% of those who survive the early complications develop one or more autoimmune conditions including hemolytic anemia, immune thrombocytopenic purpura, immune-mediated neutropenia, rheumatoid arthritis, vasculitis, and immune-mediated damage to the kidneys and liver. Individuals with a WAS-related disorder, particularly those who have been exposed to Epstein-Barr virus (EBV), are at increased risk of developing lymphomas, which often occur in unusual, extranodal locations including the brain, lung, or gastrointestinal tract. Males with XLT have thrombocytopenia with small platelets; other complications of Wiskott-Aldrich syndrome, including eczema and immune dysfunction, are usually mild or absent. Males with XLN have congenital neutropenia, myeloid dysplasia, and lymphoid cell abnormalities.
Acute febrile neutrophilic dermatosis
MedGen UID:
43097
Concept ID:
C0085077
Disease or Syndrome
Acute febrile neutrophilic dermatosis (AFND) is an autosomal dominant autoinflammatory disorder characterized by onset of recurrent fever and dermatologic abnormalities in childhood. Laboratory studies show elevated acute-phase reactants and activation of the inflammatory response, particularly IL1B (147720). Additional more variable features may include myalgia and arthralgia (summary by Masters et al., 2016).
Autoinflammatory disease, systemic, with vasculitis
MedGen UID:
1841161
Concept ID:
C5830525
Disease or Syndrome
Systemic autoinflammatory disease with vasculitis (SAIDV) is an autosomal dominant disorder that manifests soon after birth with features such as purpuric skin rash, fever, hepatosplenomegaly, and elevated C-reactive protein (CRP; 123260). Laboratory studies may show leukocytosis, thrombocytopenia, and autoantibodies. A subset of patients develop progressive liver involvement that may result in fibrosis. Other systemic features, such as periorbital edema, conjunctivitis, infections, abdominal pain, and arthralgia are usually observed. Mutations occur de novo. De Jesus et al. (2023) referred to this disorder as LAVLI (LYN kinase-associated vasculopathy and liver fibrosis).

Professional guidelines

PubMed

Dumas G, Arabi YM, Bartz R, Ranzani O, Scheibe F, Darmon M, Helms J
Intensive Care Med 2024 Jan;50(1):17-35. Epub 2023 Dec 19 doi: 10.1007/s00134-023-07266-7. PMID: 38112769
Kermani TA, Warrington KJ, Dua AB
Rheum Dis Clin North Am 2022 Aug;48(3):705-724. Epub 2022 Jul 5 doi: 10.1016/j.rdc.2022.03.006. PMID: 35953232
Fraticelli P, Benfaremo D, Gabrielli A
Intern Emerg Med 2021 Jun;16(4):831-841. Epub 2021 Mar 13 doi: 10.1007/s11739-021-02688-x. PMID: 33713282Free PMC Article

Recent clinical studies

Etiology

Kermani TA, Warrington KJ, Dua AB
Rheum Dis Clin North Am 2022 Aug;48(3):705-724. Epub 2022 Jul 5 doi: 10.1016/j.rdc.2022.03.006. PMID: 35953232
Figus FA, Piga M, Azzolin I, McConnell R, Iagnocco A
Autoimmun Rev 2021 Apr;20(4):102776. Epub 2021 Feb 17 doi: 10.1016/j.autrev.2021.102776. PMID: 33609792
Kitching AR, Anders HJ, Basu N, Brouwer E, Gordon J, Jayne DR, Kullman J, Lyons PA, Merkel PA, Savage COS, Specks U, Kain R
Nat Rev Dis Primers 2020 Aug 27;6(1):71. doi: 10.1038/s41572-020-0204-y. PMID: 32855422
McAdoo SP, Pusey CD
Clin J Am Soc Nephrol 2017 Jul 7;12(7):1162-1172. Epub 2017 May 17 doi: 10.2215/CJN.01380217. PMID: 28515156Free PMC Article
Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Ruoppolo G, Altissimi G, De Vincentiis M
Autoimmun Rev 2015 Apr;14(4):341-8. Epub 2014 Dec 11 doi: 10.1016/j.autrev.2014.12.004. PMID: 25500434

Diagnosis

Reggiani F, L'Imperio V, Calatroni M, Pagni F, Sinico RA
Clin Exp Rheumatol 2023 Apr;41(4):964-974. Epub 2023 Mar 30 doi: 10.55563/clinexprheumatol/tep3k5. PMID: 36995324
Kermani TA, Warrington KJ, Dua AB
Rheum Dis Clin North Am 2022 Aug;48(3):705-724. Epub 2022 Jul 5 doi: 10.1016/j.rdc.2022.03.006. PMID: 35953232
Fraticelli P, Benfaremo D, Gabrielli A
Intern Emerg Med 2021 Jun;16(4):831-841. Epub 2021 Mar 13 doi: 10.1007/s11739-021-02688-x. PMID: 33713282Free PMC Article
Shavit E, Alavi A, Sibbald RG
Int J Low Extrem Wounds 2018 Dec;17(4):218-226. Epub 2018 Dec 3 doi: 10.1177/1534734618804982. PMID: 30501545
Gulati K, McAdoo SP
Rheum Dis Clin North Am 2018 Nov;44(4):651-673. Epub 2018 Sep 7 doi: 10.1016/j.rdc.2018.06.011. PMID: 30274629

Therapy

Torp CK, Brüner M, Keller KK, Brouwer E, Hauge EM, McGonagle D, Kragstrup TW
Autoimmun Rev 2021 Jun;20(6):102829. Epub 2021 Apr 16 doi: 10.1016/j.autrev.2021.102829. PMID: 33872767
Figus FA, Piga M, Azzolin I, McConnell R, Iagnocco A
Autoimmun Rev 2021 Apr;20(4):102776. Epub 2021 Feb 17 doi: 10.1016/j.autrev.2021.102776. PMID: 33609792
Kitching AR, Anders HJ, Basu N, Brouwer E, Gordon J, Jayne DR, Kullman J, Lyons PA, Merkel PA, Savage COS, Specks U, Kain R
Nat Rev Dis Primers 2020 Aug 27;6(1):71. doi: 10.1038/s41572-020-0204-y. PMID: 32855422
McAdoo SP, Pusey CD
Clin J Am Soc Nephrol 2017 Jul 7;12(7):1162-1172. Epub 2017 May 17 doi: 10.2215/CJN.01380217. PMID: 28515156Free PMC Article
Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Ruoppolo G, Altissimi G, De Vincentiis M
Autoimmun Rev 2015 Apr;14(4):341-8. Epub 2014 Dec 11 doi: 10.1016/j.autrev.2014.12.004. PMID: 25500434

Prognosis

Trivioli G, Marquez A, Martorana D, Tesi M, Kronbichler A, Lyons PA, Vaglio A
Nat Rev Rheumatol 2022 Oct;18(10):559-574. Epub 2022 Sep 15 doi: 10.1038/s41584-022-00819-y. PMID: 36109667
Fraticelli P, Benfaremo D, Gabrielli A
Intern Emerg Med 2021 Jun;16(4):831-841. Epub 2021 Mar 13 doi: 10.1007/s11739-021-02688-x. PMID: 33713282Free PMC Article
Kitching AR, Anders HJ, Basu N, Brouwer E, Gordon J, Jayne DR, Kullman J, Lyons PA, Merkel PA, Savage COS, Specks U, Kain R
Nat Rev Dis Primers 2020 Aug 27;6(1):71. doi: 10.1038/s41572-020-0204-y. PMID: 32855422
Shavit E, Alavi A, Sibbald RG
Int J Low Extrem Wounds 2018 Dec;17(4):218-226. Epub 2018 Dec 3 doi: 10.1177/1534734618804982. PMID: 30501545
McAdoo SP, Pusey CD
Clin J Am Soc Nephrol 2017 Jul 7;12(7):1162-1172. Epub 2017 May 17 doi: 10.2215/CJN.01380217. PMID: 28515156Free PMC Article

Clinical prediction guides

Mertz P, Wollenschlaeger C, Chasset F, Dima A, Arnaud L
Autoimmun Rev 2023 Sep;22(9):103391. Epub 2023 Jul 17 doi: 10.1016/j.autrev.2023.103391. PMID: 37468085
Figus FA, Piga M, Azzolin I, McConnell R, Iagnocco A
Autoimmun Rev 2021 Apr;20(4):102776. Epub 2021 Feb 17 doi: 10.1016/j.autrev.2021.102776. PMID: 33609792
McAdoo SP, Pusey CD
Clin J Am Soc Nephrol 2017 Jul 7;12(7):1162-1172. Epub 2017 May 17 doi: 10.2215/CJN.01380217. PMID: 28515156Free PMC Article
Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Ruoppolo G, Altissimi G, De Vincentiis M
Autoimmun Rev 2015 Apr;14(4):341-8. Epub 2014 Dec 11 doi: 10.1016/j.autrev.2014.12.004. PMID: 25500434
Zhou Q, Yang D, Ombrello AK, Zavialov AV, Toro C, Zavialov AV, Stone DL, Chae JJ, Rosenzweig SD, Bishop K, Barron KS, Kuehn HS, Hoffmann P, Negro A, Tsai WL, Cowen EW, Pei W, Milner JD, Silvin C, Heller T, Chin DT, Patronas NJ, Barber JS, Lee CC, Wood GM, Ling A, Kelly SJ, Kleiner DE, Mullikin JC, Ganson NJ, Kong HH, Hambleton S, Candotti F, Quezado MM, Calvo KR, Alao H, Barham BK, Jones A, Meschia JF, Worrall BB, Kasner SE, Rich SS, Goldbach-Mansky R, Abinun M, Chalom E, Gotte AC, Punaro M, Pascual V, Verbsky JW, Torgerson TR, Singer NG, Gershon TR, Ozen S, Karadag O, Fleisher TA, Remmers EF, Burgess SM, Moir SL, Gadina M, Sood R, Hershfield MS, Boehm M, Kastner DL, Aksentijevich I
N Engl J Med 2014 Mar 6;370(10):911-20. Epub 2014 Feb 19 doi: 10.1056/NEJMoa1307361. PMID: 24552284Free PMC Article

Recent systematic reviews

Torp CK, Brüner M, Keller KK, Brouwer E, Hauge EM, McGonagle D, Kragstrup TW
Autoimmun Rev 2021 Jun;20(6):102829. Epub 2021 Apr 16 doi: 10.1016/j.autrev.2021.102829. PMID: 33872767
Pittam B, Gupta S, Ahmed AE, Hughes DM, Zhao SS
Rheumatol Int 2020 Aug;40(8):1215-1221. Epub 2020 Jun 4 doi: 10.1007/s00296-020-04611-7. PMID: 32494889Free PMC Article
Esposito D, Trimpou P, Giugliano D, Dehlin M, Ragnarsson O
Pituitary 2017 Oct;20(5):594-601. doi: 10.1007/s11102-017-0811-0. PMID: 28540625Free PMC Article
Loricera J, Blanco R, Hernández JL, Pina T, González-Vela MC, González-Gay MA
Int Immunopharmacol 2015 Aug;27(2):213-9. Epub 2015 Mar 28 doi: 10.1016/j.intimp.2015.03.020. PMID: 25828585
Chan M, Luqmani R
Expert Opin Pharmacother 2009 Jun;10(8):1273-89. doi: 10.1517/14656560902946401. PMID: 19445559

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