An Update on Vasculitis for the General Physician

The term vasculitis is used to describe a heterogenous group of rare disease characterised by immune-mediated damage to the blood vessels resulting in downstream ischaemia, tissue injury and end-organ damage. The classification of vasculitis is based upon the size of the vessels typically affected, which results in the broad range of clinical features associated with the different forms of vasculitis. Advances in treatment of vasculitis from the emergence of corticosteroids to the modern application of targeted immunomodulatory treatments have resulted in lower mortality associated with vasculitis but it is still associated with high healthcare resources and disease-related morbidity. Vasculitis is typically managed by rheumatologists working alongside a broad multi-disciplinary team with input from a range of medical and surgical specialties, reflecting its truly multisystem nature. Vasculitis will often present on general medical wards, with diagnosis sometimes delayed as more common infective and malignant diseases are excluded. General physicians require an understanding of the clinical features of vasculitis and have knowledge of the relevant practical approaches to investigation and management of suspected vasculitis. The present review shall provide an over-arching summary of the different forms of vasculitis and a practical approach to investigation and management aimed at the general physician.