Indian Journal of Rheumatology

REVIEW ARTICLE
Year
: 2007  |  Volume : 2  |  Issue : 4  |  Page : 141--146

Roadmap to vasculitis: a rheumatological treasure hunt


YT Konttinen1, T Pettersson2, M Matucci-Cerinic3, J Dadoniene4, P Poduval2 
1 Department of Medicine/invärtes medicin, Helsinki University Central Hospital; ORTON Orthopaedic Hospital of the Invalid Foundation, Helsinki; COXA Hospital for Joint Replacement, Tampere, Finland
2 Department of Medicine/invärtes medicin, Helsinki University Central Hospital, Finland
3 Department of Medicine, University of Florence, Florence, Italy
4 Institute of Experimental & Clinical Medicine, Vilnius University, Vilnius, Lithuania

Correspondence Address:
Y T Konttinen
Department of Medicine/invärtes medicin, Helsinki University Central Hospital; ORTON Orthopaedic Hospital of the Invalid Foundation, Helsinki; COXA Hospital for Joint Replacement, Tampere, Finland

At the stop sign we read the «DQ»red flags«DQ» and made up our mind and followed one of the road signs pointing to secondary, primary or fake vasculitis. Since then we have steadily followed the road map and passed the first (patient history and physical exam), second and third milestones (laboratory, imaging and pathology studies in the primary care and specialized centres) and have finally reached our destination at the fourth milestone (Part IV) on the road map review to vasculitis. In the management of these syndromes, Birmingham Vasculitis Activity Score (BVAS) and Vasculitis Damage Index (VDI) are not widely used in the routine clinical work, but they are introduced as the idea behind them is really valid. The backbone of the medical therapy is the use of immunosuppressive doses of prednisone (1 mg/kg/day). In some life-threatening and non-responsive vasculitides this is combined with cyclo- phosphamide 2-4 mg/kg/day or 0.5-1.0 g/m2 i.v. every 2-4 weeks (European Vasculitis group uses 15 mg/kg every 2-3 weeks), often at 3-6 months substituted either with methotrexate or azathioprine. In contrast, i.v. immunoglobulins are to be used in Kawasaki«SQ»s syndrome; cyclosporine, dapsone or colchicine in Behηet«SQ»s disease; calcium channel blockers in BACNS; and NSAID in small vessel disease; whereas plasmapheresis or immunoadsorption are added to the therapy in Goodpasture«SQ»s syndrome. Particular attention is drawn to the treatment of the triggers, use of biologicals and new cytostatic drugs and anti-metabolites, prevention of thromboembolic complications with anti-platelet drugs as well as to odd and orphan entities. A short travelogue ends our odyssey as the last sign on our roadmap.


How to cite this article:
Konttinen Y T, Pettersson T, Matucci-Cerinic M, Dadoniene J, Poduval P. Roadmap to vasculitis: a rheumatological treasure hunt.Indian J Rheumatol 2007;2:141-146


How to cite this URL:
Konttinen Y T, Pettersson T, Matucci-Cerinic M, Dadoniene J, Poduval P. Roadmap to vasculitis: a rheumatological treasure hunt. Indian J Rheumatol [serial online] 2007 [cited 2021 Jan 27 ];2:141-146
Available from: https://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2007;volume=2;issue=4;spage=141;epage=146;aulast=Konttinen;type=0