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Vasculitis is an '''inflammatory disease of blood vessels'''.  
 
Vasculitis is an '''inflammatory disease of blood vessels'''.  
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It is characteristed histologically by the accumulation of leukocytes within and around the vessel wall. It can be of neutrophilic (leukoclastic/non-leukoclastic), lymphocytic, eosinophilic, granulomatous or mixed cell type.
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It is characterised histologically by the accumulation of leukocytes within and around the vessel wall. It can be of neutrophilic (leukoclastic/non-leukoclastic), lymphocytic, eosinophilic, granulomatous or mixed cell type.
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It is a combination of '''type III and type I''' hypersensitivity reactions.  
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It is a combination of '''[[Type III Hypersensitivity|type III]] and [[Type I Hypersensitivity|type I]]''' [[:Category:Hypersensitivity|hypersensitivity]] reactions.  
    
Endothelial damage by an infectious agent, parasite infestation, eridotoxin or immune complex deposition initiates '''local inflammation, neutrophil accumulation and complement activation'''. Neutrophils release lysosomal enzymes leading to necrosis of the vessel wall, thrombosis and haemorrhage.  
 
Endothelial damage by an infectious agent, parasite infestation, eridotoxin or immune complex deposition initiates '''local inflammation, neutrophil accumulation and complement activation'''. Neutrophils release lysosomal enzymes leading to necrosis of the vessel wall, thrombosis and haemorrhage.  
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'''Staphylococcal hypersensitivity'''
 
'''Staphylococcal hypersensitivity'''
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'''Food hypersensitivity causing urticarial vasculitis'''
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'''Food hypersensitivity causing [[Urticaria|urticarial]] vasculitis'''
    
'''[[FeLV]] and [[FIV]]-associated vasculitis''' in cats
 
'''[[FeLV]] and [[FIV]]-associated vasculitis''' in cats
    
==Clinical Signs==
 
==Clinical Signs==
Clinical features of vasculitis are variable and depend on the vessels involved.
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Clinical features of vasculitis are variable and depend on the vessels involved. It can present as: purpura, haemorrhagic bullae, necrosis and punched-out ulcers. It often affects the '''extremities''' such as the '''ear tips, tail''', lips, paws and oral mucosa, and can be painful.
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It can present as: purpura, haemorrhagic bullae, necrosis and punched-out ulcers
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The systemic signs usually reflect the organ involved (hepatopathy, arthropathy, myopathy...). There may also be '''vague systemic signs of illness''': lethargy, lymphadenopathy, vague pain, pyrexia and weight loss.
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It often affects the '''extremities''' such as the '''ear tips, tail''', lips, paws and oral mucosa, and can be painful.
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Signs associated with '''immmune-mediated disease''' include: [[thrombocytopaenia]] and polyarthropathy.
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The systemic signs usually reflect the organ involved (hepatopathy, arthropathy, myopathy..)
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'''Breed-related''' vasculitis include: familial cutaneous vasculopathy of German Shepherd Dogs, neutrophilic leukoclastic vasculitis of Jack Russell Terriers, ear margin vasculitis/[[Ear Margin Dermatosis|seborrhea]] in Dachshunds.
 
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There may also be '''vague systemic signs of illness''': lethargy, lymphadenopathy, vague pain, pyrexia and weight loss.
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Signs associated with '''immmune-mediated disease''' include: thrombocytopaenia and polyarthropathy.
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'''Breed-related''' vasculitis include: familial cutaneous vasculopathy of German Shepherd Dogs, neutrophilic leukoclastic vasculitis of Jack Russell Terriers, Ear Margin Vasculitis/seborrhea in Dachshunds.
      
==Differential Diagnoses==
 
==Differential Diagnoses==
Ear margin seborrhea, chemical and thermal burns, hepatocutaneous syndrome, erythema multiforme, dermatomyositis and sepsis
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[[Ear Margin Dermatosis|Ear margin seborrhea]], chemical and thermal burns, hepatocutaneous syndrome, erythema multiforme, [[Canine Dermatomyositis|dermatomyositis]] and sepsis
    
==Diagnosis==
 
==Diagnosis==
'''Immunodiagnostics''' to consider include: ANA titre, Coombs test, and cold agglutinin test.
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'''Immunodiagnostics''' to consider include: ANA titre, [[Agglutination|Coombs test]], and cold agglutinin test.
    
'''Haematology, biochemistry and urinalysis''' may reveal a systemic disease.
 
'''Haematology, biochemistry and urinalysis''' may reveal a systemic disease.
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'''Antibiotics''' may be a first line of therapy if drug reaction is not suspected.  
 
'''Antibiotics''' may be a first line of therapy if drug reaction is not suspected.  
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'''Immune-modulatory drugs''' which may help control an immune-mediated disease with concurrent vasculitis include: prednisolone, sulfasalazine, chlorambucil.
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'''Immune-modulatory drugs''' which may help control an immune-mediated disease with concurrent vasculitis include: prednisolone, sulfasalazine, chlorambucil. These should always be used until remission and then doses decreased to the lowest possible dose for controlling clinical signs.
 
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These should always be used until remission and then doses decreased to the lowest possible dose for controlling clinical signs.
      
Prognosis is often '''guarded''', and depends on the underlying cause.
 
Prognosis is often '''guarded''', and depends on the underlying cause.
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Day, M. (2010) '''Veterinary Immunology''' ''Manson Publishing''
 
Day, M. (2010) '''Veterinary Immunology''' ''Manson Publishing''
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[[Category:To Do - Helen]]
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[[Category:To Do - Review]]
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{{review}}
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[[Category:Expert Review]]
 
[[Category:Vascular Diseases - Dog]][[Category:Vascular Diseases - Cat]]
 
[[Category:Vascular Diseases - Dog]][[Category:Vascular Diseases - Cat]]
[[Category:Arterial_Pathology]][[Category:Venous_Pathology]][[Category:To_Do_-_Cardiovascular]]
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[[Category:Arterial_Pathology]][[Category:Venous_Pathology]]
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