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Vasculitis and Vasculitides - Differential Diagnosis Framework

When to Consider Vasculitis:
 • Purpura, ischemic skin lesions
 •
- Skin, glomeruli ... often involved • Hypocomplementemic ... Urticaria and hypocomplementemia ... : - Kidneys: glomerular ... against MPO • Complement
Causes of Hypocomplementemia - CHAMPS Mnemonic
C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis
H - Heavy Chain deposition
Causes of Hypocomplementemia ... Chain deposition disease ... glomerulonephritis, type ... 1 (50%-80%), type ... #Low #Complement
Hypersensitivity Types and Their Mechanisms
Type I - lgE - Soluble antigen
 - Allergen-specific lgE antibodies bind
Hypersensitivity Types ... antigen, leading to complement ... during hemolytic disease ... Complement activation ... Diagnosis #Reactions #Table
Cryoglobulinemia Summary

Cryoglobulins:
 • Cryoglobulins are Igs in the serum that precipitate in vitro at temperatures below
• Autoimmune diseases ... Types: • Type ... • Type III Often ... • Low serum C4 complement ... • Vasculitis
Summary table of types of hypersensitivity reactions. 
Type 1
 - Mediators: lgE
 - Antigen Form: Soluble
Summary table of ... antigens, leading to complement ... reaction, Haemolytic disease ... they activate complement ... #allergy #table
Recommended initial testing for patients being evaluated for glomerular disease 

24-hour urine collection - Quantify proteinuria.
disease 24- ... or alternative complement ... disease. ... for ANCA-related vasculitis ... cryoglobulinemias (types
Vasculitis - Differential Diagnosis Framework

When to Consider Vasculitis:
• Purpura, ischemic skin lesions
• Mononeuritis multiplex
• Hematuria, proteinuria,
atherosclerotic disease ... most important diseases ... • Kidneys: Non-glomerular ... Elevated AST ALT • Hypocomplementemia ... ) • Hypocomplementemic
Rapidly Progressive Glomerulonephritis (RPGN)
RPGN has three primary pathophysiologic causes differentiated by immunofluorescence

Immune Complex Mediated (granular staining):
staining): • Low Complement ... Idiopathic • Normal Complement ... involvement: Anti-GBM Disease ... Glomerulonephritis #Vasculitis ... differential #diagnosis #algorithm
Drug Induced Kidney Injury
 • Pre-Renal: NSAIDS, CNI, ACEI/ARB, IL-2 therapy, Diuretics CAR-T therapy
 • Osmotic
Vitamin C • Glomerular ... Disease: Drug induced ... vasculitis, TMA ... differential #diagnosis #algorithm
Recommended initial testing for patients being evaluated for glomerular disease
1) 24-hour urine collection - Quantify proteinuria.
disease 1) 24- ... or alternative complement ... for ANCA-related vasculitis ... cryoglobulinemias (types ... #glomerular #disease