Vasculitis de mediano vaso

Abstract

Medium-vessel vasculitides are inflammatory diseases that mainly affect medium muscle and visceral arteries, causing necrotizing inflammation. They include polyarteritis nodosa (PAN), Kawasaki disease (KD), and ANCA-associated vasculitis (AAV). PAN is a rare vasculitis that affects medium-sized vessels. It is characterized by systemic symptoms such as fever, weight loss, and involvement of organs such as the skin, kidneys, and nerves. Its diagnosis is based on histology and imaging techniques which show characteristic aneurysms. Treatment includes corticosteroids and immunosuppressants. KD, more common in children, affects coronary arteries and manifests as persistent fever, conjunctivitis, lymphadenopathy, and mucocutaneous lesions. Management includes intravenous immunoglobulins and acetylsalicylic acid to prevent aneurysms. AAVs are necrotizing vasculitides and include granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA). These affect small- and medium-sized vessels, with frequent involvement of the kidneys, lungs, and upper respiratory tract. Diagnosis is based on ANCA positivity and confirmed by biopsy. Treatment depends on the severity, considering that it can be life-threatening, and combines immunosuppressants such as rituximab or cyclophosphamide with corticosteroids.