Systemic vasculitis

Systemic vasculitis is a general term designating a wide range of sometimes overlapping vascular conditions with marked tropism for peripheral constituting a complex nosological structure. Angiologists must be aware of the different telltale clinical signs including purpura, polyarthritis, glomerulonephritis, polyneuritis and unexplained inflammatory syndrome. Medium-sized and small-sized vessels are involved in a wide range of visceral damage. Several typical clinical presentations have led to the individualization of recognized syndromes such as rheumatoid type purpura, Wegener disease, Churg disease, Strauss disease, or peri-arteritis nodosa. Anti-nuclear serologies (pANCA and cANCA) contribute to diagnosis and have been helpful in individualizing a new entity: microscopic polyangeitis. In angiological practice, macroscopic expression of systemic vasculitis can lead to Takayasu type granulomatous angeitis in yong women and giant-cell arteritis in the elderly. These different arteriopathies should be treated by corticosteroid therapy with regular laboratory tests to follow inflammation and angiograhic exploration in case of occlusive arterial complications. Although these conditions are quite rare, a better understanding of their pathogenesis and their clinical course should help the angiologist make the initial diagnosis and the therapist to monitor treatment efficacy.