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© Dirk Biddle
A number of primary vasculitis conditions have been defined by the American College of Rheumatology (ACR) under the broad category of rheumatic diseases (1), also referred to as connective tissue disorders or collagen related diseases. The common feature of this group of diseases is widespread inflammatory damage to connective tissues and blood vessels, and the deposition of fibrinoid material (2). However, in vasculitis conditions, the blood vessels are the central target of acute immune injury, whereas in the connective tissue diseases blood vessels are just one of the targets. Nevertheless The American College of Rheumatology (ACR) considers vasculitis “A Puzzler Among Rheumatic Diseases” (3) and has developed classification criteria for some primary vasculitides including Churg-Strauss Syndrome, Giant Cell (Temporal) Arteritis, Hypersensitivity vasculitis (Cutaneous leukocytoclastic angiitis), Giant cell (Temporal) arteritis, Henoch-Schönlein purpura, Polyarteritis Nodosa, Takayasu’s arteritis, and Wegener’s granulomatosis (1). The ACR diagnostic criteria have been widely criticised (4) and it is debatable whether this rheumatologic categorisation of some of the primary vasculitides will stand the test of time.
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1. American College of Rheumatology: Clasification criteria
(http://www.rheumatology.org/publications/classification/index.asp?aud=mem)
2. Buckingham, E., Bailey, B., Quinn, F. (2000) Connective Tissue Diseases: Grand Rounds Presentation, UTMB, Dept. of Otolaryngology (http://www.otohns.net/default.asp?id=4160).
3. Matteson, E. (2005) A Puzzler among Rheumatic Diseases. American College of Rheumatology (http://www.rheumatology.org/public/usatoday/vasculitis.asp).
4. Rao, J., Allen, N, Pincus, T. (1998) Limitations of the 1990 American College of Rheumatology classification criteria in the diagnosis of vasculitis. Annuls of Internal Medicine, 129(5), 345-52.
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