Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Clinical review: Vasculitis on the intensive care unit – part 1: diagnosis. | Critical Care February 2005 Vol 9 No 1 Semple et al. Review Clinical review Vasculitis on the intensive care unit - part 1 diagnosis David Semple1 James Keogh2 Luigi Forni3 and Richard Venn4 Specialist Registrar Renal Medicine Worthing Hospital Worthing UK Specialist Registrar Anaesthetics Worthing Hospital Worthing UK 3Consultant Physician Worthing Hospital Worthing UK 4Consultant Anaesthetist Worthing Hospital Worthing UK Corresponding author David Semple Published online 18 August 2004 This article is online at http content 9 1 92 2004 BioMed Central Ltd Critical Care 2005 9 92-97 DOI cc2936 Abstract The first part of this review addresses the diagnosis and differential diagnosis of the primary vasculitides Wegener s granulomatosis microscopic polyangiitis Churg-Strauss syndrome and polyarteritis nodosa. Prompt diagnosis and treatment of these conditions ensures an optimal prognosis. The development of assays for antineutrophil cytoplasmic antibodies has aided the diagnosis of Wegener s granulomatosis and microscopic polyangiitis. However even in cases where there is high clinical likelihood that these conditions are present up to 20 may be antibody negative whereas alternative diagnoses may be antibody positive. The final diagnosis rests on a balance of clinical laboratory radiological and histological features. The exclusion of alternative diagnoses is important in assuring appropriate therapy. Particular attention is paid to the more fulminant presentations of these conditions and the role of the critical care physician in their diagnosis and management. Keywords antineutrophil cytoplasmic antibody critical care Churg-Strauss syndrome diagnosis microscopic polyangiitis polyarteritis nodosa vasculitis Wegener s granulomatosis Introduction Systemic necrotizing vasculitis represents a major challenge in critical care units. The prognosis of a fulminating vasculitic illness is poor. For example patients admitted to the
