Bajocchi G, Cavazza A
Rheumatology Unit, S. Maria Hospital - USL, IRCCS Institute, Reggio Emilia.
Reumatismo. 2018 Oct 3;70(3):155-164. doi: 10.4081/reumatismo.2018.1096.
The range of pathologies that are related to primitive vasculitis is broad, complex and not as typical as we would expect. Clinicians should be aware that several forms of primitive and systemic vasculitis, regardless of the size of the affected vessel, may exhibit identical histological alterations. This observation has important clinical implications as it means that cases of vasculitis do not correspond clinically and histologically. Thus, while histology remains the diagnostic gold standard, it can be used only as part of the most complete clinical assessment possible. Another point worth of the clinician's attention is that vasculitis histology changes over time, as do disease evolution and activity, even without considering the masking effects of treatment and the possibility of sampling error due to the patchy occurrence of vasculitis. The purpose of this review is to identify the most common forms of vasculitis in clinical practice, and to provide guidance to the clinician on the pathology of the vessels.
与原发性血管炎相关的病理范围广泛、复杂,且不像我们预期的那样典型。临床医生应意识到,几种原发性和系统性血管炎形式,无论受影响血管的大小如何,都可能表现出相同的组织学改变。这一观察结果具有重要的临床意义,因为它意味着血管炎病例在临床和组织学上并不对应。因此,虽然组织学仍然是诊断的金标准,但它只能作为尽可能完整的临床评估的一部分使用。临床医生另一个值得关注的点是,即使不考虑治疗的掩盖作用以及由于血管炎的散在发生而导致抽样误差的可能性,血管炎的组织学也会随着时间而变化,疾病的演变和活动也是如此。本综述的目的是确定临床实践中最常见的血管炎形式,并为临床医生提供关于血管病理学的指导。