Differential Diagnosis for Vasculitis of Medium Sized Muscular Arteries
Single Most Likely Diagnosis
- Polyarteritis Nodosa (PAN): This is the most likely diagnosis because PAN is a systemic vasculitis that predominantly affects medium-sized muscular arteries, leading to aneurysm formation and organ damage. It presents with a wide range of symptoms, including hypertension, kidney involvement, and neurological manifestations.
Other Likely Diagnoses
- Kawasaki Disease: Although more common in children, Kawasaki disease can affect adults and involves inflammation of medium-sized arteries, particularly the coronary arteries. It is characterized by fever, rash, lymphadenopathy, and desquamation of the hands and feet.
- ANCA-Associated Vasculitis (AAV): This includes conditions like Granulomatosis with Polyangiitis (GPA), Microscopic Polyangiitis (MPA), and Eosinophilic Granulomatosis with Polyangiitis (EGPA). While AAV can affect smaller vessels, some forms can involve medium-sized arteries, especially in the context of GPA.
Do Not Miss Diagnoses
- Hepatitis B-Associated Vasculitis: This condition can cause vasculitis of medium-sized arteries and is crucial to identify due to its association with hepatitis B infection. Missing this diagnosis could lead to delayed treatment and significant morbidity.
- Infectious Vasculitis: Vasculitis caused by infections such as syphilis or tuberculosis can affect medium-sized arteries. Identifying an infectious cause is critical for appropriate antimicrobial treatment.
Rare Diagnoses
- Primary Central Nervous System Vasculitis (PCNSV): This rare condition involves inflammation of the blood vessels in the brain and spinal cord, which can include medium-sized arteries. It presents with neurological symptoms and can be challenging to diagnose.
- Cogan Syndrome: A rare disorder characterized by vasculitis and inflammation of the eyes and ears, which can also involve medium-sized arteries. It is essential to consider in patients with ocular and auditory symptoms.
- Ehlers-Danlos Syndrome with Vasculitis: Some types of Ehlers-Danlos syndrome can involve vascular complications, including vasculitis of medium-sized arteries, due to the underlying connective tissue disorder.