+ Health and Sciences +

Buerger's disease is also called Thromboarteritis obliterans. It occurs in young males mostly below 40 years. It is common in Israel, South America and India. It is strongly associated with heavy smoking and caffeine. It mostly involves smalls and medium arteries and veins of the extremities. Pathology: Recurrent neutrophilic vasculitis with micro abscesses. Segmental thrombosis- leads to vascular insufficiency. Clinical features: Severe pain (claudication) in the affected extremity Thrombophlebitis Raynaud phenomenon Ulceration and gangrene Treatment : Treatment is symptomatic and cessation of smoking. View a case: Example

Arteriosclerosis can be defined as a group of diseases that result in arterial wall thickening. 1. Monckeberg medial calcific sclerosis: Medial calcification of medium sized arteries Femoral, tibial, radial and ulnar arteries are affected mostly. It is mostly asymptomatic and can be detected by X ray 2. Arteriosclerosis: Occurs in diabetes, hypertension and aging Affects small arteries and arterioles Microscopic appearance- Hyaline arteriosclerosis- pink, glossy arterial wall thickening with luminal narrowing is noted. Hyperplastic arteriosclerosis- Smooth muscle proliferation resulting in concentric (onion skin) wall thickening and luminal narrowing. 3. Atherosclerosis: Def: Lipid deposition and intimal thickening of large and medium sized arteries, resulting in fatty streaks and atheromatous plaques. Aorta, coronary arteries, carotid, cerebral, iliac and popliteal arteries Fatty streak- flat, yellow intimal streak. Microscopically, lipid laden macrophages can be se...

Definition: Congenital or acquired weakness of vessel wall media, resulting in a localized dilation or out pouching. The bulge in the aneurysm may burst and death may occur any time. 1. Atherosclerotic aneurysms: Weakening of media secondary to atheroma formation Occur in the abdominal aorta below the real arteries Associated with hypertension Half of aortic aneurysms > 6cm in diameter will rupture within 10 years 2.Aortic dissecting aneurysms Its due to cystic medial necrosis of tunica media. Blood from the vessel lumen enters the intimal tear and dissects through the layers of media. It presents with severe tearing pain. It may compress and obstruct the aortic the aortic branches (eg- renal or coronary arteries) HTN and Marfan syndrome are predisposing factors. 3. Syphilitic aneurysms: Involves ascending aorta Syphilitic (leutic) aortitis causes an obliterative endarteritis of the vasa vasoram. Leading to ischemia and smooth muscle atrophy of aortic media. May dilate the aortic ...

Most common form of vasculitis. Affects females more than males. Primarily affects the elderly population. Temporal arteritis is associated with HLA-DR4 Distribution of the disease: 1. Small and medium sized arteries 2. Cranial arteries (temporal, facial and ophthalmic arteries) 2. Aortic arch-giant cell aortitis (uncommon) Clinical features: 1. Throbbing headache- Mostly unilateral 2. Tender firm temporal arteries 3. Visual disturbances- Blurred vision, double vision, visual loss. 4. Facial pain 5. Fever, Malaise, Weight loss, muscle aches, anemia 6. Polymyalgia rheumatica: systemic flu like symptoms and joint involvement (pain, morning stiffness in neck, shoulders and hips). Laboratory findings- Elevated ESR Pathology- 1. Segmental granulomatous vaculitis 2. Fragmentation of internal elastic lamina 3. Intimal fibrosis with luminal narrowing. Diagnosis- Temporal arterial biopsy, classical presentation or rapid onset may be treated empirically Treatment - Corticosteroids

Wagner's granulomatosis is a kind of autoimmune disorder affecting the arteries. Medium sized and small arteries are involved. This is a kind of necrotizing vasculitis with granulomas. Its more common in males than in females. Mostly occurs at the age group of 40-60. Classically involves Nose, Sinuses, Lungs and kidneys. Clinical Features: Bilateral pneumonitis with nodular and cavity pulmonary infiltrates. Chronic sinusitis. Nasopharyngeal ulcerations. Focal necrotizing glomerulosclerosis and Crescentic glomerulosclerosis are the two important forms of Renal pathology observed. Microscopic picture: Fibrinoid necrosis, Neutrophils and granulomas. Lab findings: Cytoplasmic antineutrophil cytoplasmic auto antibodies(C-ANCA) Auto antibody against proteinase 3 Diagnosis is confirmed by biopsy Treatment is by giving immunosuppresive drugs like Cyclophosphamide.