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Vasculitis in the critically ill 

Vasculitis in the critically ill
Chapter:
Vasculitis in the critically ill
Author(s):

Karina A. Keogh

DOI:
10.1093/med/9780199600830.003.0277
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date: 01 August 2021

The vasculitic syndromes are a heterogeneous group of rare disorders characterized by degrees of inflammation and necrosis of blood vessels with a wide variety of clinical manifestations. Intensive care treatment is most commonly required for vasculitis involving small blood vessels, including capillaries. Involvement of these vessels in the lung causes alveolar haemorrhage, which may lead to respiratory failure. In the kidneys it may cause glomerulonephritis leading to renal failure. Severe cardiac, neurological, and gastrointestinal manifestions can also be seen. Non-vasculitic manifestations may also be present, such as pulmonary nodules secondary to granulomatous inflammation in granulomatosis with polyangiitis. Diagnosis is based primarily on history and physical exam in conjunction with radiographic and serological testing. Intensive care unit admission is typically secondary to end organ damage due to inflammation, or because of side effects from the cytotoxic therapies, particularly infection. Treatment of vasculitis includes supportive management in conjunction with immunosuppression. Standard treatment of severe disease consists of corticosteroids and cytotoxic drugs.

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