Systemic vasculitis.

Systemic vasculitis is a general term designating a wide range of sometimes overlapping vascular conditions with marked tropism for peripheral constit uting a complex nosological structure. Angiologists must be aware of the di fferent telltale clinical signs including purpura, polyarthritis, glomerulo nephritis, polyneuritis and unexplained inflammatory syndrome. Medium-sized and small-sized vessels are involved in a wide range of viscer al damage. Several typical clinical presentations have led to the individua lization of recognized syndromes such as rheumatoid type purpura, Wegener d isease, Churg disease, Strauss disease, or peri-arteritis nodosa. Anti-nucl ear serologies (pANCA and cANCA) contribute to diagnosis and have been help ful in individualizing a new entity: microscopic polyangeitis. In angiological practice, macroscopic expression of systemic vasculitis can lead to Takayasu type granulomatous angeitis in yong women and giant-cell arteritis in the elderly. These different arteriopathies should be treated by corticosteroid therapy with regular laboratory tests to follow inflammation and angiograhic explor ation in case of occlusive arterial complications. Although these condition s are quite rare, a better understanding of their pathogenesis and their cl inical course should help the angiologist make the initial diagnosis and th e therapist to monitor treatment efficacy.