Vasculitis. Concepto, clasificación, mecanismos etiopatogénicos y criterios de sospecha clínica

Abstract

Vasculitides are a group of inflammatory diseases that affect blood vessels, generating a wide spectrum of clinical manifestations and outcomes. This update reviews the basic concepts, classification, etiopathogenic mechanisms, and criteria for clinical suspicion. The current classification, based mainly on the size of the affected vessels, provides a useful yet limited framework, given the heterogeneity and overlap among subtypes. Advances in genetics and epigenetics have improved the understanding of predisposing and triggering factors while immunological mechanisms offer clues to understanding the underlying inflammatory process. Early diagnosis is essential to prevent serious complications, but there are challenges due to the nonspecificity of symptoms and the coexistence of diseases that may mimic vasculitis. Pseudovasculitis, for example, has similar clinical and radiological features, which underscores the importance of a careful assessment. The combination of an initial clinical evaluation with modern diagnostic tools opens new perspectives for more effective management adjusted to each patient's specific characteristics.