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Humanized Mouse Model to Study Bacterial Infections Targeting the Microvasculature
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Infection associated Vasculitides.

Ramesh Jois1, Radhika Bajaj1

  • 1Department of Clinical Immunology and Rheumatology, Manipal Hospital, Millers Road, Bangalore, India.

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Summary

Infections can mimic primary systemic vasculitis, presenting similar symptoms and requiring careful diagnosis. Awareness of these mimicking infections is crucial to avoid potentially fatal immunosuppression in patients.

Keywords:
Drug-induced vasculitisInfection-associated vasculitidesSecondary vasculitisVasculitis mimics

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Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Immunology

Background:

  • Infections can present clinical and investigative similarities to Primary Systemic Vasculitis (PSV).
  • Distinguishing between infection and PSV is critical as immunosuppression in infected patients can be fatal.
  • Infections may mimic small, medium, or large vessel vasculitis and induce autoantibodies like Anti-neutrophil cytoplasmic antibody (ANCA) via molecular mimicry.

Purpose of the Study:

  • To highlight the importance of recognizing infections that mimic vasculitis.
  • To discuss the potential for infections to cause or be associated with vasculitis.
  • To inform clinicians about differential diagnoses in suspected vasculitis cases.

Main Methods:

  • Review of clinical presentations and diagnostic challenges in differentiating infections from vasculitis.
  • Discussion of proposed pathogenetic mechanisms for infection-associated vasculitis.
  • Consideration of iatrogenic causes of vasculitis, including drugs and immune checkpoint inhibitors.

Main Results:

  • Infections share significant overlap in clinical features and diagnostic findings with PSV.
  • COVID-19 associated vasculitis is a recent addition to the spectrum of infection-mimicking vasculitis.
  • Drug-induced vasculitis and immune checkpoint inhibitor-induced vasculitis are also recognized entities.

Conclusions:

  • Clinicians must maintain a high index of suspicion for infections in patients presenting with vasculitis-like symptoms.
  • Accurate diagnosis is paramount to guide appropriate treatment and avoid adverse outcomes from immunosuppression.
  • The differential diagnosis of vasculitis should encompass infectious etiologies, drug reactions, and iatrogenic causes.