Vasculitis in Clinical Practice by Richard A. Watts, David G. I. Scott, Chetan Mukhtyar

By Richard A. Watts, David G. I. Scott, Chetan Mukhtyar

This booklet makes a speciality of medical presentation, diagnostic strategies and present administration of systematic vasculitis, and for this moment variation the Editors have up to date the remedy strategy and nomenclature in accordance with present perform. Systemic vasculitides are a gaggle of issues that are of accelerating value. lots of those stipulations are just not often encountered via basic physicians and infrequently current major diagnostic demanding situations. The Editors objective to supply simply available info in a pocket sized layout. In doing so that they wish to assist either the generalist but in addition rheumatologists who merely come upon those difficulties occasionally.

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Vasculitis in Clinical Practice

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Some patients may recall the exact date and hour their symptoms started. In most instances, symptoms are insidious and develop gradually over several weeks. 1 Systemic Constitutional features, including fever, fatigue, anorexia, weight loss, and depression are present in the majority of patients. Patients may present with pyrexia of unknown origin. Myalgia and arthralgia with morning stiffness across the shoulder and hip girdle is suggestive of coexistent PMR. 2 Craniofacial Headache is the most common symptom occurring in >60 % of patients.

Attention to the primary prevention of cardiovascular risk should be made; in particular, the treatment of hypertension and hypercholesterolemia. Advice on smoking cessation, healthy diet, and regular exercise should be given. 34 Chapter 4. 10 Detection and Prevention of the Adverse Effects of Therapy Treatment for systemic vasculitis often requires high-dose glucocorticoids, cyclophosphamide, or other immunosuppressive agents, which are associated with potential toxicity. This toxicity can be ameliorated with appropriate prophylaxis.

General Principles of Treatment aims for a maximum duration of CYC therapy of 6–12 months when successful remission has been achieved [4]. In patients with AAV who have achieved successful remission (usually between 3 and 6 months), cyclophosphamide should be withdrawn and substituted with either azathioprine in combination with oral steroids [4, 5]. Methotrexate, mycophenolate or leflunomide may be used as alternatives for intolerance or lack of efficacy of AZA. Azathioprine is the conventional choice for remission maintenance.

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