Algoritmo diagnóstico de vasculites primárias

Alexandre Sacchetti Bezerra

Faculdade de Medicina do ABC, Disciplina de Angiologia e Cirurgia Vascular, Santo André, SP, Brasil.

Afonso César Polimanti

Faculdade de Medicina do ABC, Disciplina de Angiologia e Cirurgia Vascular, Santo André, SP, Brasil.

Rafael Vilhena de Carvalho Fürst

Faculdade de Medicina do ABC, Disciplina de Angiologia e Cirurgia Vascular, Santo André, SP, Brasil.

João Antônio Corrêa

Faculdade de Medicina do ABC, Disciplina de Angiologia e Cirurgia Vascular, Santo André, SP, Brasil.

Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Correspondence Alexandre Sacchetti Bezerra Av. Eng. Luiz Carlos Berrini, 1748, sala 810 CEP 04571-000 - São Paulo (SP), Brasil Tel.: +55 (11) 2893-6661 / +55 (11) 2893-6662 E-mail: a.bezerr@uol.com.br

Author information ASB - Full member, Sociedade Brasileira de Angiologia e Cirurgia Vascular. ACP and RVCF - Professors, Disciplina de Angiologia e Cirurgia Vascular, Faculdade de Medicina do ABC. JAC - Full professor, Disciplina de Angiologia e Cirurgia Vascular, Faculdade de Medicina do ABC.

Author contributions Conception and design: ASB Analysis and interpretation: ASB, ACP Data collection: ASB, ACP, RVCF Writing the article: ASB, ACP Critical revision of the article: ASB, ACP, JAC Final approval of the article*: ASB, ACP, RVCF, JAC Statistical analysis: N/A. Overall responsibility: ASB

*All authors have read and approved of the final version of the article submitted to J Vasc Bras.

Vessel caliber	Disease
Large vessel vasculitis (> 150 mm)	Takayasu arteritis
Large vessel vasculitis (> 150 mm)	Giant cell arteritis
Medium vessel vasculitis (50-150 mm)	Polyarteritis nodosa
Medium vessel vasculitis (50-150 mm)	Kawasaki disease
Small vessel vasculitis (<50 mm)	Granulomatosis with polyangiitis (Wegener’s)
	Microscopic polyangiitis
	Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss)
	IgA vasculitis (Henoch-Schönlein)
	Cryoglobulinemic vasculitis I, II and III
	Cutaneous vasculitis
	Behçet’s disease
	Leukocytoclastic vasculitis

Vessel caliber	Disease	CHC2012 definition
Large vessel vasculitis (> 150 mm)	Takayasu arteritis	Arteritis, often granulomatous, predominantly affecting the aorta and/or its major branches. Onset usually in patients younger than 50 years.
	Giant cell arteritis	Arteritis, often granulomatous, usually affecting the aorta and/or its major branches, with a predilection for the branches of the carotid and vertebral arteries. Often involves the temporal artery. Onset usually in patients older than 50 years and often associated with polymyalgia rheumatica.
Medium vessel vasculitis (50-150 mm)	Polyarteritis nodosa	Necrotizing arteritis of medium or small arteries without glomerulonephritis or vasculitis in arterioles, capillaries, or venules, and not associated with antineutrophil cytoplasmic antibodies (ANCAs).
	Kawasaki disease	Arteritis associated with the mucocutaneous lymph node syndrome and predominantly affecting medium and small arteries. Coronary arteries are often involved. Aorta and large arteries may be involved. Usually occurs in infants and young children.

Exams	Average cost in US dollars
Complement; antigen; each component	10.50
CH50	19.39
Duplex scan of lower extremity arteries	143.39
IgM	10.50
Percutaneous transluminal coronary angiography	337.22
IgG	10.50
Transcranial Doppler study	157.43
Myeloperoxidase (MPO)	18.91
Antistreptolysin O	5.20
Proteinase 3 (PR3)	18.91
Antinuclear antibodies	5.20
Rheumatoid factor	4.88
IgA	10.50
Echocardiography	211.40
Cryoglobulins	5.48
Esophagus, gastroesophageal reflux test	389.18
Sedimentation rate	2.00
C reactive protein	4.10
HIV test	15.17
Nerve conduction studies	189.42
Duplex scan of extracranial arteries	144.46
Hepatitis B serology	40.40
Hepatitis C antibody	19.13
Intravascular Doppler velocity	220.45
Blood count; leukocyte (WBC); automated	3.13

Exams	Average Cost in US Dollars
Complement; antigen; each component	4.49
CH50	2.42
Duplex scan of lower extremity arteries	10.36
IgM	4.49
Percutaneous transluminal coronary angiography	160.92
IgG	4.85
Transcranial Doppler study	30.62
Myeloperoxidase (MPO)	^* * No financial reference in DATASUS 13 .
Antistreptolysin O	0.74
Proteinase 3 (PR3)	*
Antinuclear antibodies	4.49
Rheumatoid factor	1.07
IgA	4.85
Echocardiography	10.45
Cryoglobulins	0.60
Esophagus, gastroesophageal reflux test	35.43
Sedimentation rate	0.71
C reactive protein	0.74
HIV test	22.25
Nerve conduction studies	7.06
Hepatitis B serology	4.85
Hepatitis C antibody	4.85
Intravascular Doppler velocity	*
Blood count; leukocyte (WBC); automated	0.71

Brasil