Moffitt AM report PEARLS 7/10: mononeuritis multiplex, leukocytoclastic vasculitis, AND a bit on HSP/PAN

  • Mononeuritis multiplex: top 3 ddx = HIV, DM, and VASCULITIS
  • Leukocytoclastic vasculitis: is a pathologic diagnosis, NOT a disease! Still a broad ddx. See this great flow chart by Dr. Sarah Goglin (rheum) that Kevin pulled up but we didn’t get a chance to walk through – save it for future use!!!
    • LCV
  • Approach to treatment for vasculitis
    • Small vessel à rx with steroids alone!
      • Ex: HSP – classically, palpable purpura of lower ext and buttocks. Bx with LCV + IgA deposition to confirm dx.
    • Medium vessel à need steroids AND other immunotherapy (cyclophosphamide)!
      • Ex: PAN – classically, a systemic necrotizing vasculitis with systemic sxs. A/w hep B/C and hairy cell leukemia. Renal manifestation is commonly HTN. On angiogram, see “rosary sign” (small aneurysms strung like leads of a rosary).

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