Mimics of vasculitis

Rheumatology (Oxford). 2021 Jan 5;60(1):34-47. doi: 10.1093/rheumatology/keaa495.

Abstract

While prompt diagnosis of vasculitis is important, recognition of vasculitis mimics is equally essential. As in the case of vasculitis, an approach to mimics based on the anatomic size of vessels can be useful. Infections can mimic vasculitis of any vessel size, including the formation of aneurysms and induction of ANCAs. Genetic disorders and vasculopathies are important considerations in large and medium vessel vasculitis. Cholesterol emboli, thrombotic conditions and calciphylaxis typically affect the medium and small vessels and, like vasculitis, can cause cutaneous, renal and CNS manifestations. Reversible cerebral vasoconstriction syndrome is important to distinguish from primary angiitis of the CNS. As an incorrect diagnosis of vasculitis can result in harmful consequences, it is imperative that the evaluation of suspected vasculitis includes consideration of mimics. We discuss the above mimics and outline a systematic and practical approach for differentiating vasculitis from its mimics.

Keywords: aneurysm; calciphylaxis; cholesterol emboli; endocarditis; mimics; thrombosis; vasculitis; vasculopathy.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Embolism, Cholesterol / diagnosis
  • Endocarditis / diagnosis
  • Humans
  • Thrombophilia / diagnosis
  • Vasculitis / diagnosis*