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Vasculitides in older people 

Vasculitides in older people
Chapter:
Vasculitides in older people
Author(s):

Alexis Régent

and Loïc Guillevin

DOI:
10.1093/med/9780198701590.003.0074
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date: 20 August 2019

Vasculitides are a heterogeneous group of diseases, defined by vessel inflammation with fibrinoid necrosis of the arterial wall, giant-cell infiltration, and/or granuloma. Patients with giant cell arteritis (GCA) often have headaches, polymyalgia rheumatica, and vision symptoms in a context of moderately impaired health. Microscopic polyangiitis symptoms are very diverse, including alveolar haemorrhage, rapidly progressive glomerulonephritis, skin ulcers, mononeuritis multiplex, muscle, and joint pain. Other vasculitides, such as granulomatosis with polyangiitis (Wegener’s) (GPA) or cryoglobulinemic vasculitis occur less frequently in older patients. Diagnoses are based on clinical manifestations, laboratory results, imaging findings, and the established classification of vasculitides according to vessel size and histological findings. The treatment regimen, based on glucocorticoids and immunosuppressants, is chosen according to diagnosis and predictable outcome, and adapted to the patient’s age and concomitant comorbidities.

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