Differential Diagnosis for Small Cell Vasculitis with Gangrene
- Single most likely diagnosis
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis, GPA): This condition is a form of vasculitis that affects small- to medium-sized vessels and is known for its association with anti-neutrophil cytoplasmic antibodies (ANCA). It can cause a wide range of symptoms, including those affecting the respiratory tract and kidneys, and can lead to gangrene due to the vascular inflammation.
- Other Likely diagnoses
- Microscopic Polyangiitis (MPA): Another ANCA-associated vasculitis, MPA primarily affects small-sized blood vessels and can lead to organ damage, including renal and pulmonary involvement. Gangrene can occur due to the inflammation of small vessels.
- Eosinophilic Granulomatosis with Polyangiitis (EGPA, Churg-Strauss Syndrome): This is a type of vasculitis that is also associated with ANCA and eosinophilia. It can affect various organs and, in severe cases, lead to gangrene.
- Polyarteritis Nodosa (PAN): Although PAN typically affects medium-sized vessels, it can sometimes involve smaller vessels and lead to gangrene. It is not associated with ANCA but can cause significant vascular inflammation.
- Do Not Miss diagnoses
- Infectious Vasculitis: Certain infections can cause vasculitis, which may lead to gangrene. Identifying and treating the underlying infection is crucial.
- Cryoglobulinemic Vasculitis: This condition is caused by the deposition of cryoglobulins (proteins that precipitate in cold temperatures) in blood vessel walls, leading to inflammation and potential gangrene. It is often associated with hepatitis C infection.
- Vasculitis due to Drug Reaction: Certain drugs can induce vasculitis as an adverse reaction, which may present with gangrene. Early recognition and withdrawal of the offending drug are vital.
- Rare diagnoses
- Kawasaki Disease: Although primarily seen in children, Kawasaki disease can cause vasculitis of medium-sized vessels and, in rare cases, may lead to gangrene.
- Buerger's Disease (Thromboangiitis Obliterans): This is a rare disease of the blood vessels in the arms and legs, which can lead to gangrene. It is strongly associated with smoking.
- Primary Central Nervous System Vasculitis: While this condition primarily affects the vessels of the central nervous system, in rare instances, it can lead to systemic manifestations, including gangrene, especially if there is significant involvement of vessels outside the CNS.