Vasculitis in children: Management overview
- David Cabral, MBBS, FRCPC
David Cabral, MBBS, FRCPC
- Clinical Professor of Pediatrics, Head, Division of Rheumatology, Department of Pediatrics
- University of British Columbia
- Kimberly Morishita, MD, MHSc, FRCPC
Kimberly Morishita, MD, MHSc, FRCPC
- Clinical Assistant Professor of Pediatrics
- Division of Rheumatology, Department of Pediatrics
- University of British Columbia
Vasculitis is defined as the presence of inflammation in a blood vessel that may occur as a primary process or secondary to an underlying disease. Clinical symptoms vary widely. The various vasculitic syndromes are defined by both the type of pathologic inflammation and the type and location of the vessels and this, in turn, determines which specific organs are affected [1,2].
The first priorities in management of a child with vasculitis are prompt recognition and timely treatment since many of the vasculitides can be severe and life-threatening conditions if not appropriately managed. Specific treatments are determined by the type of vasculitis, the severity of the inflammation, and the particular organ systems affected.
A general overview of the management of vasculitis in children is reviewed here. The classification and the approach to evaluating childhood vasculitis are discussed separately. (See "Vasculitis in children: Classification and incidence" and "Vasculitis in children: Evaluation".)
GENERAL PRINCIPLES OF MANAGEMENT
The following principles are important to consider when managing a child with vasculitis:
●Differentiating vasculitis from other diseases that can either mimic vasculitis or cause secondary vasculitis
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- GENERAL PRINCIPLES OF MANAGEMENT
- Differentiating vasculitis from other diseases
- Defining disease activity
- Weighing the benefits and risks of therapy
- Key questions
- Cutaneous vasculitis
- Central nervous system vasculitis
- Systemic vasculitis
- - Acute and self-limited disorders
- - Chronic disorders
- Induction and maintenance therapy
- Therapy for refractory or relapsing disease
- Adjunctive therapy for severe disease
- - Supportive care
- PATIENT MONITORING
- Clinical features
- Laboratory tests
- Imaging studies
- Tissue biopsy
- Disease-activity scoring
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS