Department of Rheumatology and Immunology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland.
Immunodeficiency Laboratory, Department of Biomedicine, University Hospital and University of Basel, Basel, Switzerland.
Curr Rheumatol Rep. 2022 Nov;24(11):352-370. doi: 10.1007/s11926-022-01086-2. Epub 2022 Sep 27.
To provide a comprehensive overview of the spectrum of large and medium vessel vasculitis in adults with primary vasculitides, arthritides, connective tissue, and fibroinflammatory diseases as well as vasculitis mimics, for an efficient differential diagnosis and initial diagnostic approach.
Imaging has had a tremendous impact on the diagnosis of medium to large vessel vasculitis, now often replacing histopathologic confirmation and identifying new disease manifestations (e.g., intracranial disease in giant cell arteritis; vascular manifestations of IgG4-related disease). Novel diseases or syndromes involving blood vessels have been described (e.g., VEXAS-Syndrome with polychondritis). The use of the terms "medium" or "large" vessel varies considerably between medical specialties. The differential diagnosis of large and medium vessel vasculitis is becoming increasingly complex as new entities or disease manifestations of known inflammatory rheumatic diseases are regularly identified. A more precise and widely recognized definition of the vessel sizes would make future research more comparable.
为了对原发性血管炎、关节炎、结缔组织病和纤维炎性疾病以及血管炎类似疾病患者的大、中血管血管炎谱进行全面概述,以便进行有效的鉴别诊断和初始诊断方法。
影像学对中到大血管血管炎的诊断产生了巨大影响,现在通常替代组织病理学确认,并识别出新的疾病表现(例如巨细胞动脉炎中的颅内疾病;IgG4 相关疾病的血管表现)。新的涉及血管的疾病或综合征已被描述(例如伴有多软骨炎的 VEXAS 综合征)。“中”或“大”血管的术语在不同医学专业之间差异很大。随着不断发现新的实体或已知炎症性风湿性疾病的疾病表现,大、中血管血管炎的鉴别诊断变得越来越复杂。更精确和广泛认可的血管大小定义将使未来的研究更具可比性。