Vaskulárna medicína 3/2010

Secondary vasculitides associated to connective tissue diseases and drug-related vasculitides

Secondary vasculitides usually accompany various common and rare conditions and their clinical picture is very diverse. Most frequently, we find parainfectious, drug-related and paraneoplastic vasculitides, less commonly vasculitides in connective tissue diseases, after radiotherapy or transplantation. Vasculitides may be associated to infection of any origin – usually to viruses, bacteria and parasites. Drug-related vasculitides are mainly confined to the skin with picture of leukocytoclastic angiitis but visceral organs may be involved too. Paraneoplastic vasculitides accompany solid tumours and lymphoproliferative processes. When related to connective tissue diseases we commonly observe vasculitis in rheumatoid arthritis, systemic lupus erythematosus, Sjoegren syndrome, systemic sclerosis, dermatomyositis, rheumatic fever, relapsing polychondritis and mixed connective tissue disease. Vasculitis in rheumatoid arthritis has usually three forms: vessel involvement in the pathogenesis of rheumatoid arthritis, autonomous vasculitis of digital arteries, and „clinical rheumatoid vasculitis“ syndrome. The diagnosis of vasculitis is usually based on pathological findings from biopsy. Management of secondary vasculitis lies in treatment of underlying disease and if it is ineffective combined immunosuppression should be introduced.

Keywords: vasculitis, infection, neoplasms, connective tissue diseases, rheumatoid arthritis