Vasculitis from the Rheumatologist’s Viewpoint
Vasculitis presents clinically as a spectrum of disease involving one to many organs. This causes problems with classification, particularly in early cases. The evolution of the disease frequently uncovers significant pointers to the true diagnosis. In addition, the pattern of organ involvement and severity may differ considerably between patients with the same label. Thus it is unlikely that any single clinician will be referred the entire spectrum of these uncommon disorders. The answer lies in close collaboration between specialists, as well as in inducing a low threshold for considering the diagnosis amongst a broad range of colleagues. Probably the pathologist is the only person to see the true scale of disease in individual cases, since he sees end stage disease which has had time to accrue the full features. It is no coincidence that the description of the disease which bears Wegener’s name followed detailed pathological studies. Hopefully, this will become less true in the future now that the prognosis for vasculitis has improved with more effective therapy. One effect of such therapy will be to alter the classical disease pattern so that pathologists, seeing the failures of treatment, will record more complications of both disease and therapy.
KeywordsRheumatoid Arthritis Renal Involvement Systemic Vasculitis Tracheal Stenosis Pulse Regime
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