title: Vasculitis related to viral and other microbial agents.
abstract: Vasculitis due to infection may occur as a consequence of the inflammation of vessel walls due to direct or contiguous infection, type II or immune complex-mediated reaction, cell-mediated hypersensitivity, or inflammation due to immune dysregulation triggered by bacterial toxin and/or superantigen production. As immunosuppressive therapy administered in the absence of antimicrobial therapy may increase morbidity and fail to effect the resolution of infection-associated vascular inflammation, it is important to consider infectious entities as potential inciting factors in vasculitis syndromes. The causality between infection and vasculitis has been established in hepatitis B-associated polyarteritis nodosa (HBV-PAN) and hepatitis C-associated (cryoglobulinemic) vasculitis (HCV-CV). The review summarizes the recent literature on the pathophysiological mechanisms and the approaches to the management of HBV-PAN and HCV-CV. Roles of other viral and microbial infections, which either manifest as vasculitic syndromes or are implicated in the pathogenesis of primary vasculitides, are also discussed.
authors.affiliation: Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
authors.forename: Gim Gee
authors.initials: GG
authors.lastname: Teng
authors.affiliation: Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: wchatham@uab.edu.
authors.forename: W Winn
authors.initials: WW
authors.lastname: Chatham
mesh_terms: D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D003449:Cryoglobulinemia / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D010488:Polyarteritis Nodosa / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D014657:Vasculitis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy / Q000821:virology*
keywords: Cryoglobulinemia; Cryoglobulinemic vasculitis; Hepatitis B; Hepatitis C; Polyarteritis nodosa; Vasculitis