Pediatric Vasculitis: Recognizing Multisystemic Manifestations at Body Imaging

Abstract

Pediatric vasculitides are multisystem diseases that can be diagnostic challenges because of variable clinical manifestations. The clinical manifestation is determined by the size of the affected vessels, organs involved, extent of vascular injury, and underlying pathologic characteristics. Henoch-Schönlein purpura and Kawasaki disease are the two most common subtypes of pediatric vasculitis. Diagnosis of pediatric vasculitis can be difficult, and the outcome can be serious or fatal in the absence of timely intervention. Imaging plays a central role in establishing the diagnosis of vasculitis involving large- and medium-sized vessels, visualizing its vascular and extravascular manifestations, and monitoring the disease course and response to treatment. Although imaging cannot depict the vessel changes of small-vessel vasculitis directly, it can be used to detect tissue damage resulting from vessel inflammation. This article discusses the classification and clinical features of the major pediatric vasculitides. The imaging approach to and nonneurologic findings of major pediatric vasculitis subtypes are reviewed for the pediatric body imager.

Abnormalities of the Coronary Arteries in Children: Looking beyond the Origins

“…can enable evaluation for associated findings such as myocarditis and pericarditis and assessment of myocardial function. Imaging findings of KD include coronary arterial ectasia and aneurysms, lack of normal tapering, and increased perivascular echogenicity (13) (Figs 2, 3). Coronary arterial aneurysms in KD are more likely to develop in the proximal coronary arterial systems, with the proximal LAD and proximal RCA being the most common sites.…”

“…Presenting symptoms are nonspecific and include fever, myalgia, arthralgia, and skin lesions (18). The most commonly involved organ systems are the skin, renal, and gastrointestinal systems; cardiac involvement is less common (13,18). At laboratory analysis, patients may have positive hepatitis B virus (HBV) surface antigen, although HBV-associated polyarteritis nodosa is less common in children (13).…”

“…Involvement of medium-sized visceral arteries is characteristic in polyarteritis nodosa, primarily involving the renal, hepatic, and mesenteric arterial vasculature. Aneurysms of the visceral arterial vasculature at conventional angiography are generally accepted as diagnostic (13). Other findings include arterial beading and caliber variations, arterial tapering, stenosis, occlusion, and pruning of the peripheral vasculature (20).…”

Ураження Нирок При Геморагічному Васкуліті Шенлейна — Геноха, Що Почався В Дитячому І Дорослому Віці

“…Ежегодная заболеваемость ГВ достигает 2 чeловек на 10 тыс. населения, причем наблюдается повсеместный рост численности таких больных [6,15].…”

Ураження Суглобів При Пурпурі Шенлайна-Геноха

“…Еже-годная заболеваемость ПШГ достигает 2 чeловек на 10 тыс. населения, причем наблюдается повсемест-ный рост численности больных [5,9]. Необходимо отметить, что болезнь может либо дебютировать во взрослом возрасте (реже), либо трансформировать-ся из ювенильной ПШГ, при этом особенности даль-нейшей эволюции патологического процесса остают-ся неизученными [1,3,6].…”