Roadmap to vasculitis

Vasculitis is characterized by vessel wall injury caused by an immunologically initiated inflammatory reaction. Vesselwall injuryleads to vascular stenosis, aneurysm, bleeding, thrombosis, embolism, vasospasms and ischemia. The vasculitis is clinically important when the patient has general inflammatory and multifocal symptoms, which progress in episodes and can be explained by these vascular lesions. The clinical manifestations of these depend on the size, localization and number of blood vessels involved. This forms the basis of the current vasculitis classification. It is important to recognize the secondary vasculitides, as their treatment is mainly based on elimination of the triggering factor. In primary vasculitides, immunosuppression alone is the basis of treatment in almost all cases, whereas the management of pseudovasculitis is dependent on its aetiology. In primary care, basic evaluation should be done: patient history, physical examination, basic laboratory tests and other non-invasive tests to verify suspected surrogate findings. After this, patients should be urgently referred to a specialized centre, where the required histological and radiological tests are performed for diagnosis and immunosuppressive and other necessary treatment is initiated.