Found this in an old not in an old app and thought it was still a reasonable summary for EM purposes
Summarised from rosens 8th chapter 116
As always, happy to take comments and more importantly corrections!
- Digital cyanosis
- initially fever weight loss constitutional symptoms
- late followed by pulse differences and limb ischemia
- affects internal (supplying the eye) and external (supplying masseter and superficial temporal) arteries.
- if amaurosis fugax think GCA and stroke.
- smoking is key
- typically lower limb pain and claudication.
- associated ulceration
- chronic relapsing
- oral ulceration early and essential
- eye involvement about 70% (iritis)
- can affect both small and large vessels
- respiratory tract and kidneys
- commonest manifestations are sinus related so good luck trying to diagnose that
- can present as glomerulonephritis which will hopefully be easier
- high (>80% 1 year mortality untreated)
- linked with atopy (part of the diagnosis)
- usually a couple of years of asthma symptoms prior to diagnosis
- commonest cause of pulmonary renal syndrome (haemoptysis and glomerulonephritis)
- mainly seen as rapidly progressive renal impairment
- I struggle to see anything that would clinically help me differentiate this from microscopic polyangiitis
- both have alveolar bleeding and renal failure
- this is one we actually see fairly commonly
- Often a preceding URTI
- rash arthralgia commonest
- Abdominal pain and kidney problems too
- usually self limiting over about 2 months
- recurs in up to a third
- usually drug related(though hard to prove)
- skin findings like HSP but no systemic findings
- cryoglobulins are immune complexes that precipitate at 4 degrees
- purpura weakness arthralgias
- viral infections hep b and c EBV and CMV
- if the cryoglobulins precipitate in the kidneys then there’s problems
- inflammation of venules of skin
- strep sarcoid and TB are things that should come to mind.
- Inflammatory bowel disease is a very uncommon cause of nodosum.