Kallenberg C G, Tervaert J W
Academisch Ziekenhuis, afd. Inwendige Geneeskunde, Groningen.
Ned Tijdschr Geneeskd. 1998 Jan 17;142(3):118-23.
A diagnosis of vasculitis generally requires histopathological proof of vasculitis, particularly because many other disease entities may mimic vasculitis ('vasculitis-look-alikes'). Vasculitis can be primary (idiopathic) or secondary to other diseases, especially infectious diseases. The primary vasculitides are classified according to the size of the vessels involved and the nature of the inflammation, in combination with clinical symptoms. The detection of autoantibodies, particularly the antineutrophil cytoplasmic antibodies (ANCA), in some of the primary vasculitides, has facilitated the diagnosis of those diseases and has given more insight into their pathophysiology. Treatment of primary vasculitis still consists of corticosteroids whether or not in combination with immunosuppression. New insights in pathophysiology may provide more specific and less toxic treatment modalities.
血管炎的诊断通常需要血管炎的组织病理学证据，特别是因为许多其他疾病实体可能会模仿血管炎（“血管炎样疾病”）。血管炎可以是原发性（特发性）的，也可以是继发于其他疾病，尤其是传染病。原发性血管炎根据受累血管的大小、炎症性质以及临床症状进行分类。在一些原发性血管炎中检测自身抗体，尤其是抗中性粒细胞胞浆抗体（ANCA），有助于这些疾病的诊断，并能更深入地了解其病理生理学。原发性血管炎的治疗仍然包括使用糖皮质激素，无论是否联合免疫抑制治疗。病理生理学方面的新见解可能会提供更具特异性且毒性更小的治疗方式。
