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GPA treatment depends on the severity of the disease. [8] Severe disease is typically treated with a combination of immunosuppressive medications such as rituximab or cyclophosphamide and high-dose corticosteroids to control the symptoms of the disease and azathioprine , methotrexate , or rituximab to keep the disease under control.
Eosinophilic granulomatosis with polyangiitis consists of three stages, but not all patients develop all three stages or progress from one stage to the next in the same order; [7] whereas some patients may develop severe or life-threatening complications such as gastrointestinal involvement and heart disease, some patients are only mildly affected, e.g. with skin lesions and nasal polyps. [8]
Lupus vasculitis: Small to medium vessels in multiple organs ANA, anti-dsDNA, anti-Smith, others Confirmed [39] Rheumatoid vasculitis: Small to medium vessels in skin, nerves, eyes, heart Rheumatoid factor, ACPA Probable [40] Microscopic polyangiitis (MPA) Small vessels in kidneys, lungs, nerves, skin p-ANCA/MPO-ANCA Confirmed [41]
The disease's symptoms can range from catastrophic neurological impairment to an asymptomatic condition brought on by impalpable pulses or bruits. [7] Non-specific features include mild anemia, myalgia, arthralgia, weight loss, malaise, night sweats, and fever. [8] Giant cell arteritis (GCA) is the most common type of systemic vasculitis in adults.
The signs and symptoms of microscopic polyangiitis may resemble those of granulomatosis with polyangiitis (GPA) (another form of small-vessel vasculitis) but typically lacks the significant upper respiratory tract involvement (e.g., sinusitis) frequently seen in people affected by GPA. [citation needed]
ANCA will less commonly form against alternative antigens that may also result in a p-ANCA pattern. These include lactoferrin, elastase, and cathepsin G. [citation needed] When the condition is a vasculitis, the target is usually MPO. [1] However, the proportion of p-ANCA sera with anti-MPO antibodies has been reported to be as low as 12%. [2]
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The definite diagnosis of vasculitis is established after a biopsy of involved organ or tissue, such as skin, sinuses, lung, nerve, brain, and kidney. The biopsy elucidates the pattern of blood vessel inflammation. Some types of vasculitis display leukocytoclasis, which is vascular damage caused by nuclear debris from infiltrating neutrophils. [37]