Inducing remission in systemic vasculitides

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

Systemic vasculitis requires specialist management, especially when the manifestation(s) threaten a major organ or body system (eg glomerulonephritis, pulmonary haemorrhage, intestinal ischaemia, sight-threatening eye disease, neuropathy).

In all cases of systemic vasculitis, the aim of treatment is to induce and maintain remission of disease activity. Remission of disease activity is defined as:

• absence of clinical features of vasculitis
• resolution of organ changes or stabilisation of organ structure and function
• normalisation of inflammatory markers (serum C-reactive protein [CRP] concentration, erythrocyte sedimentation rate [ESR]).