Vasculitis Damage

Pulmonary vasculitis damage to vascular smooth muscle cells proliferation of endothelium and vascular connective tissue in the liver... 

Exley AR, Bacon PA, Luqmani RA, et al. Examination of disease severity in systemic vasculitis from the novel perspective of damage using the vasculitis damage index (VDI). Br J Rheumatol 1998 37(l) 57-63. 

Intrinsic Vascular damage Hypercalcemia Hepatorenal syndrome Vasculitis Polyarteritis nodosa Hemolytic uremic syndrom thrombotic thrombocytopenic purpura Emboli Atherosclerotic Thrombotic... 

Type 3, immune complex vasculitis (serum sickness, Arthus reaction). Drug-antibody complexes precipitate on vascular walls, complement is activated, and an inflammatory reaction is triggered. Attracted neutrophils, in a futile attempt to phagocytose the complexes, liberate lysosomal enzymes that damage the vascular walls (inflammation, vasculitis). Symptoms may include fever, exanthema swelling of lymph nodes, arthritis, nephritis, and neuropathy. 

Trimethoprim produces the predictable adverse effects of an antifolate drug, especially megaloblastic anemia, leukopenia, and granulocytopenia. The combination trimethoprim-sulfamethoxazole may cause all of the untoward reactions associated with sulfonamides. Nausea and vomiting, drug fever, vasculitis, renal damage, and central nervous system disturbances occasionally occur also. Patients with AIDS and pneumocystis pneumonia have a particularly high frequency of untoward reactions to trimethoprim-sulfamethoxazole, especially fever, rashes, leukopenia, diarrhea, elevations of hepatic aminotransferases, hyperkalemia, and hyponatremia. 

A 30-year-old man developed destructive rhinitis due to cocaine abuse after initially presenting with Henoch-Schonlein purpura (121). Cocaine use can mimic vasculitis and is often accompanied by positive ANCAs. Cocaine-induced midline destructive lesions are characterized by mucosal damage and ischemic necrosis of the nasal septum. Histopathological similarity to leukocytoclastic vasculitis and the presence of PR3-ANCA can lead to confusion between Wegener s granulomatosis and cocaine-induced midline destructive lesions. 

There have been three studies of the effects of percutaneous ethanol injections in the treatment of hepatocellular carcinoma, either alone (12,13) or in combination with transcatheter arterial embolization (14). The procedure was effective and safe and improved long-term survival. Adverse effects were generally mild and of short duration, and commonly included abdominal pain, fever, intoxication (especially among non-drinkers), transient rises in serum transaminases, and chemical thrombosis of the tributary branch of the portal vein. Hepatic infarction has been reported in two patients with hepatocellular carcinoma after percutaneous ethanol injection of the tumors (15). Both patients had previously been treated with transcatheter arterial infusion using a suspension of styrene maleic acid neocarzinostatin, and the liver damage may have occurred through a combination of arterial damage due to the neocarzinostatin and vasculitis caused by flow of the injected ethanol into a portal vein branch. 

In a 56-year-old man with a transitional cell carcinoma of the bladder gemcitabine plus cisplatin caused extensive necrotizing vasculitis with muscle damage after the second course of therapy (20). Chemotherapy was withdrawn immediately but the symptoms of... 

BoyerTD, Sun N, ReynoldsTB. Allopurinol-hypersensitivity. Vasculitis and liver damage. West J Med 1977 126 143-147. 

Drug-induced cutaneous necrotizing vasculitis, a clinicopathologic process characterized by inflammation and necrosis of blood vessels, often presents with a variety of small, palpable purpuric lesions most frequently distributed over the lower extremities urticaria-like lesions, small ulcerations, and occasional hemorrhagic vesicles and pustules. The basic process involves an immunologically mediated response to antigens that result in vessel wall damage. 

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