Skip to main content
Log in

Vaskulitiden

EULAR-/ACR-Leitlinien im Spiegel des klinisch-kardiologischen Alltags

Vasculitis

EULAR/ACR guidelines with respect to the clinical cardiological routine

  • CME Zertifizierte Fortbildung
  • Published:
Herz Aims and scope Submit manuscript

Zusammenfassung

In diesem Beitrag werden klinische Diagnostik, Differenzialdiagnostik, Laboruntersuchungen, multimodale Bildgebung sowie die medikamentöse Therapie der Vaskulitiden der kleinen, mittleren und großen Gefäße sowie granulomatöser und eosinophiler Erkrankungen in Anlehnung an die EULAR- und ACR-Empfehlungen beschrieben. Vaskulitiden sind ein Syndrom. Die einzelnen spezifischen Krankheitsbilder umfassen klinische Entitäten wie die Wegener-Granulomatose, die Polyangiitis, das Churg-Strauss-Syndrom, die Polyarteriitis (Panarteriitis) nodosa, die Kryglobulinämie und sonstige Vaskulitiden.

Abstract

In this article the diagnostics, differential diagnosis, laboratory findings, multimodal imaging and treatment of vasculitis of small, medium and large vessels as well as granulomatous and eosinophilic vascular diseases are described in the context of previous and current European League against Rheumatism (EULAR) and American College of Rheumatology (ACR) recommendations. Vasculitis is a syndrome which is part of various clinical disease entities, such as Wegener’s granulomatosis, polyangiitis, Churg-Strauss syndrome, polyarteritis nodosa, cryoglobulinemia and other forms of vasculitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Hunder GG, Bloch DA, Michael BA et al (1990) The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 33:1122–1128

    Article  CAS  PubMed  Google Scholar 

  2. Jennette JC, Falk RJ, Andrassy K et al (1994) Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum 37:187–192

    Article  CAS  PubMed  Google Scholar 

  3. Jennette JC, Falk RJ, Bacon PA et al (2013) 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 65:1–11

    Article  CAS  PubMed  Google Scholar 

  4. Watts RA, Jolliffe VA, Carruthers DM et al (1996) Effect of classification on the incidence of polyarteritis nodosa and microscopic polyangiitis. Arthritis Rheum 39:1208–1212

    Article  CAS  PubMed  Google Scholar 

  5. Luqmani RA, Suppiah R, Grayson PC et al (2011) Nomenclature and classifification of vasculitis – update on the ACR/EULAR diagnosis and classification of vasculitis study (DCVAS). Clin Exp Immunol 164(Suppl 1):11–13

    Article  PubMed Central  PubMed  Google Scholar 

  6. Watts RA, Suppish R, Merkel PA, Luqmani R (2011) Systemic vasculitis – is it time to reclassify? The way forward in approaching a diagnosis of vasculitis (Editorial). Rheumatology 50:643–645

    Article  PubMed  Google Scholar 

  7. Ozen S, Ruperto N, Dillon MJ et al (2005) EULAR/PReS endorsed consensus criteria for the classification of childhood vasculitides. Ann Rheum Dis 65:939–941

    Google Scholar 

  8. Yildiz C, Ozen S (2013) Childhood vasculitis. Acta Medica 2:16–22

    Google Scholar 

  9. Hernandez-Rodrıguez J, Molloy ES, Hoffman GS (2008) Single-organ vasculitis. Curr Opin Rheumatol 20(1):40–46

    Article  PubMed  Google Scholar 

  10. Classen M, Diehl V, Kochsiek K (2004) Innere Medizin, 5. Aufl. Urban & Fischer, München Jena

  11. Numano F (2002) The story of Takayasu arteritis. Rheumatology 41(1):103–106

    Article  CAS  PubMed  Google Scholar 

  12. Horton BT, Magath TB, Brown GE (1932) An undescribed form of arteritis of the temporal vessels. Proc Mayo Clin 7:700–701

    Google Scholar 

  13. Ness T, Bley TA, Schmidt WA, Lamprecht P (2013) The diagnosis and treatment of giant cell arteritis. Dtsch Arztebl Int 110(21):376–386

    PubMed Central  PubMed  Google Scholar 

  14. Mukhtyar C, Guillevin L, Cid MC (2009) EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis 68:318–323

    Article  CAS  PubMed  Google Scholar 

  15. Mazlumzadeh M, Hunder GG, Easley KA et al (2006) Treatment of giant cell arteritis using induction therapy with high-dose glucocorticoids: a double-blind, placebo-controlled, randomized prospective clinical trial. Arthritis Rheum 54:3310–3318

    Article  CAS  PubMed  Google Scholar 

  16. Lightfoot RW, Michel BA, Bloch DA et al (1990) The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum 33:1088–1093

    Article  PubMed  Google Scholar 

  17. Mukhtyar C, Guillevin L, Cid MC et al (2009) EULAR recommendations for the management of primary small and medium vessel vasculitis. Ann Rheum Dis 68:310–317

    Article  CAS  PubMed  Google Scholar 

  18. Kussmaul A, Maier R (1866) Über eine bisher nicht beschriebene eigenthümliche Arterienerkrankung (Periarteriitis nodosa), die mit Morbus Brightii und rapid fortschreitender allgemeiner Muskellähmung einhergeht. Dtsch Arch Klin Med 1:484–515

    Google Scholar 

  19. Gross WL (ed) (1993) ANCA associated vasculitides, vol. 336. Plenum Press, New York London

  20. Parrillo JE (1990) Heart disease and the eosinophil. N Engl J Med 323:1560–1561

    Article  CAS  PubMed  Google Scholar 

  21. Baandrup U (2012) Eosinophilic myocarditis. Herz 8:849–853

    Article  Google Scholar 

  22. Ogbogu PU, Rosing DR, Horne MK (2007) Cardiovascular manifestations of hypereosinophilic syndromes. Immunol Allergy Clin North Am 27:457–475

    Article  PubMed Central  PubMed  Google Scholar 

  23. Maisch B, Richter A, Koelsch S et al (2006) Management of patients with suspected (peri-) myocarditis and inflammatory dilated cardiomyopathy. Herz 31(9):881–890

    Article  PubMed  Google Scholar 

  24. Maisch B, Pankuweit S (2013) Standard and etiology-directed evidence-based therapies in myocarditis: state of the art and future perspectives. Heart Fail Rev 18(6):761–795

    Article  CAS  PubMed  Google Scholar 

  25. Maisch B, Ruppert V, Pankuweit S (2014) Management of fulminant myocarditis: a diagnosis in search of its etiology but with therapeutic options. Curr Heart Fail Rep 11(2):166–177

    Article  CAS  PubMed  Google Scholar 

  26. Maisch B, Seferovic PM, Ristic AD et al (2004) Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European Society of Cardiology. Eur Heart J 25(7):587–610

    Article  PubMed  Google Scholar 

  27. Maisch B, Ristic AD, Seferovic PM, Tsang TSM (2011) Interventional pericardiology. Springer, Berlin Heidelberg New York

  28. Maisch B, Ristic AD, Pankuweit S (2002) Intrapericardial treatment of autoreactive pericardial effusion with triamcinolone; the way to avoid side effects of systemic corticosteroid therapy. Eur Heart J 23(19):1503–1508

    Article  CAS  PubMed  Google Scholar 

  29. Cogan DC (1945) Syndrome of nonsyphilitic interstitial keratitis and vestibuloauditory symptoms. Arch Ophthalmol 33:144–149

    Article  Google Scholar 

  30. Lunardi C, Bason C, Leandri M et al (2002) Autoantibodies to inner ear and endothelial antigens in Cogan’s syndrome. Lancet 360(9337):915–921

    Article  CAS  PubMed  Google Scholar 

  31. Walter MA, Melzer RA, Schindler C et al (2005) The value of 18F-FDG PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Eur J Nucl Med Mol Imaging 32:674–681

    Article  PubMed  Google Scholar 

  32. Balink H, Bruyn GA (2007) The role of PET/CT in Cogan’s syndrome. Clin Rheumatol 26:2177–2179

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Maisch B, Ristic AD (2014) Diagnostik und Therapie der Perikarditis und des Perikardergusses. Herz 39:837–856

    Article  CAS  PubMed  Google Scholar 

  34. Dasgupta B, Cimmino MA, Maradit-Kremers H et al (2012) 2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 71:484–492

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. B. Maisch gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B. Maisch.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maisch, B. Vaskulitiden. Herz 40, 85–98 (2015). https://doi.org/10.1007/s00059-014-4200-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00059-014-4200-4

Schlüsselwörter

Keywords

Navigation