Management overview for systemic vasculitides

Systemic vasculitides require specialist management. If a systemic vasculitis is strongly suspected, seek urgent specialist advice to determine if immediate treatment should be instituted. Rheumatologists often have fast-track triage systems for these people and strongly encourage direct contact by general practitioners to expedite referral or to obtain advice on treatment (eg before starting systemic corticosteroids).

While a management approach can be described, its application varies for each of the systemic vasculitides. Consider both the advice here, and specific management advice covered in separate topics:

• Giant cell arteritis (GCA)
• Takayasu arteritis
• Polyarteritis nodosa
• ANCA-associated vasculitides
• Cryoglobulinaemia and cryoglobulinaemic vasculitis.

Initially, the systemic vasculitides listed above are managed with intensive induction therapy, using high-dose systemic corticosteroids and, in some circumstances, immunomodulatory drugs.

Immunoglobulin A vasculitis and Kawasaki disease are managed very differently; see specific management in the separate topics.