• Leukocytoclastic vasculitis, also called leukocytoclastic cutaneous angiitis, is the most common form of vasculitis. (bvsalud.org)
  • other causes of pulmonary-renal syndrome (see Granulomatosis With Polyangiitis ), cutaneous leukocytoclastic angiitis. (empendium.com)
  • Granulomatosis with polyangiitis is the third most common type of vasculitis in Iran after Behcet's disease and cutaneous leukocytoclastic angiitis [6]. (rheumres.org)
  • Vasculitis refers to a large group of diseases, also known as angiitis, that damage blood vessels by causing inflammation. (medicalnewstoday.com)
  • Vasculitis is also called angiitis and arteritis. (medicalnewstoday.com)
  • Vasculitis affecting the small vessels of the skin (eg, arterioles, capillaries, postcapillary venules) tends to cause lesions such as purpura, petechiae, and possibly shallow ulcers. (msdmanuals.com)
  • Skin biopsy of lower extremity lesions was compatible with leukocytoclastic vasculitis. (bvsalud.org)
  • Annular lesions can present in a variety of diseases. (aafp.org)
  • Many diseases present with cutaneous annular lesions, making distinction by physical appearance alone challenging. (aafp.org)
  • Limited cutaneous lesions are more common than severe necrotizing complications, which are rare. (rheumaknowledgy.com)
  • Patients whose vasculitis is limited to fingertip lesions generally do well, whereas involvement of major nerves or arteries in organs such as the heart is associated with a poorer prognosis. (rheumaknowledgy.com)
  • The following data were analysed: age of onset of disease, sex, duration of disease at diagnosis and during follow-up, topography and description of cutaneous lesions, treatment regimen and response, and duration of follow-up. (medicaljournals.se)
  • Many cutaneous side effects have been reported with their use in rheumatoid arthritis including psoriasis , dermatitis , leukocytoclastic vasculitis, lichenoid drug eruptions , and non-infectious cutaneous granulomatous reactions, such as disseminated granuloma annulare , sarcoidosis-like lesions, and interstitial granulomatous dermatitis. (arthritisdaily.net)
  • We present this a case of EED with vesicular lesions associated with rheumatoid arthritis and pANCA positivity. (edoj.org.eg)
  • A clinical diagnosis of cutaneous vasculitis was considered, the primary differential for the cutaneous lesions being erythema elevatum diutinum. (edoj.org.eg)
  • Rheumatoid arthritis was considered as the primary systemic diagnosis (The diagnosis of EED mainly being based on the nature and distribution of the lesions, and the known association of EED with rheumatoid arthritis and vasculitis). (edoj.org.eg)
  • Cutaneous lesions are excluded from the study. (who.int)
  • [11] Cutaneous lesions are tender to touch but rarely pruritic with an asymmetrical distribution that favors the upper extremities. (eyewiki.org)
  • At least three out of five criteria yields sensitivity and specificity of 95 and 91%: Age at onset ≥ 50 years New onset headache with localized tenderness Temporal artery tenderness or decreased pulsation Elevated ESR ≥ 50 mm/hour Westergren Temporal artery biopsy showing vasculitis with mononuclear cell infiltrate or granulomatous inflammation, usually with multinucleated giant cells These conditions are sometimes considered together with the small vessel vasculitides. (wikipedia.org)
  • Patients have CNS symptoms as well as cerebral vasculitis by angiography and leptomeningeal biopsy. (wikipedia.org)
  • If the patient has renal failure or cutaneous vasculitis, these are the most logical organs to obtain a biopsy from. (checkorphan.org)
  • On histopathological examination, a biopsy will show leukocytoclastic vasculitis with necrotic changes and granulomatous inflammation (clumps of typically arranged white blood cells) on microscopy. (checkorphan.org)
  • Skin biopsy revealed small and intermediate vessel vasculitis. (scielo.org.za)
  • Vasculitis was reported as the cause of death on postmortem biopsy. (scielo.org.za)
  • A skin biopsy from the lesion demonstrated a neutrophilic vasculitis and blood investigations significantly showed a pANCA (Peripheral Anti-Neutrophilic Cytoplasmic Antibody) and rheumatoid factor positivity. (edoj.org.eg)
  • A skin biopsy demonstrated a prominent neutrophilic vasculitis with subepidermal clefting in the specimen taken from the vesicular area [Fig4 and Fig5] . (edoj.org.eg)
  • Histological examination from the left medial thigh punch biopsy revealed predominantly lobular neutrophilic panniculitis without dermal infiltrate, papillary dermal edema, or vasculitis. (juniperpublishers.com)
  • The presence of chronic urticaria, abdominal pain, hypocomplementemia, and leukocytoclastic vasculitis on skin biopsy confirmed the diagnosis of HUVS. (hspioa.org)
  • Here we identified three unrelated boys with perinatal-onset of neutrophilic cutaneous small vessel vasculitis and systemic inflammation. (nature.com)
  • all presented with systemic inflammation and recurrent neutrophilic small vessel vasculitis. (nature.com)
  • Cutaneous small-vessel vasculitis is often idiopathic , but all patients should be evaluated for potential underlying causes, including infections (e.g. (amboss.com)
  • The pathological mechanism that causes cutaneous small-vessel vasculitis can also cause vasculitides in organs other than the skin , which are categorized as distinct diseases. (amboss.com)
  • Vasculitis is a rare, inflammatory condition of the blood vessels whereby excess leukocytes within the vessel leads to a loss of structural integrity, and possible destruction. (faoj.org)
  • We present a case of small and medium-vessel vasculitis on the lower extremity with cutaneous manifestations, without an identifiable cause. (faoj.org)
  • Vasculitis varies and may be classified based on the size of the blood vessel involved. (faoj.org)
  • Although Wegener's granulomatosis affects small and medium-sized vessels, it is formally classified as one of the small vessel vasculitides in the Chapel Hill system. (checkorphan.org)
  • CSVV sometimes refers to small-vessel vasculitis of unknown cause (also called idiopathic cutaneous small-vessel vasculitis). (msdmanuals.com)
  • Vasculitis is inflammation of the blood vessel walls. (printo.it)
  • 1.4 What happens to the blood vessel in vasculitis? (printo.it)
  • Vasculitis classification in children is based on the size of the blood vessel involved. (printo.it)
  • Large vessel vasculitis, like Takayasu arteritis, affects the aorta and its major branches. (printo.it)
  • Medium vessel vasculitis typically affects arteries supplying the kidneys, bowels, brain or heart (e.g. polyarteritis nodosa, Kawasaki disease). (printo.it)
  • Drug-induced vasculitis is an inflammation of small-sized blood vessel caused by the use of drugs. (koreamed.org)
  • Fever and cutaneous manifestations that reflect neutrophilic dermatosis, leukocytoclastic vasculitis, or medium-vessel vasculitis are common in patients with VEXAS syndrome. (nejm.org)
  • [6] Takayasu's arteritis is an example of a large-vessel vasculitis in childhood, whereas Kawasaki disease and polyarteritis nodosa are examples of medium-vessel vasculitis disorders. (scielo.org.za)
  • Vasculitis can affect any blood vessel anywhere in the body. (medicalnewstoday.com)
  • Some forms of vasculitis are characterized by giant cells in the vessel wall. (merckmanuals.com)
  • Granulomatosis with Polyangiitis (GPA) Granulomatosis with polyangiitis is characterized by necrotizing granulomatous inflammation, small- and medium-sized vessel vasculitis, and focal necrotizing glomerulonephritis, often with crescent. (merckmanuals.com)
  • the vessel inflammation (true vasculitis) is only part of the pathophysiology and there is predominant parenchymal inflammation in a characteristic pattern that involves specific organs. (merckmanuals.com)
  • Leukocytoclastic vasculitis is a histopathologic term used to describe findings in small-vessel vasculitis. (merckmanuals.com)
  • Necrotizing vasculitis, also called systemic necrotizing vasculitus, is a category of vasculitis, comprising vasculitides that present with necrosis. (wikipedia.org)
  • Vasculitis is an uncommon condition characterized by inflammation and necrosis of blood vessels and impaired blood flow. (cohencenters.com)
  • Overview of Vasculitis Vasculitis is inflammation of blood vessels, often with ischemia, necrosis, and organ inflammation. (msdmanuals.com)
  • Other clinical entities that can present similarly to heparin-induced skin necrosis include calciphylaxis, pyoderma gangrenosum, disseminated intravascular coagulation (DIC), leukocytoclastic vasculitis, and other bullous disorders. (clinicaladvisor.com)
  • Its use was discontinued when patients began exhibiting serious side effects including agranulocytosis, thrombocytopenia, arthritis, vasculitis and skin necrosis. (jetem.org)
  • 4 The most common complication is the need for surgical consultation and debridement if the vasculitis leads to skin necrosis. (jetem.org)
  • Aurora N, Janin T, Bhanot R, Natesan S. Levamisole-induced leukocytoclastic vasculitis and neutropenia in a patient with cocaine use: an extensive case with necrosis of skin, soft tissue and cartilage. (jetem.org)
  • Methamphetamine and other sympathomimetics can cause a cerebral vasculitis alongside polyarteritis nodosa like systemic features. (wikipedia.org)
  • Polyarteritis nodosa, granulomatosis with polyangiitis, Henoch-Schönlein purpura, scleroderma, and otherwise nonspecified vasculitides also were reported to have caused ESRD during this period. (medscape.com)
  • Specifically, patients with VEXAS syndrome can meet diagnostic or classification criteria for one or more diseases, including relapsing polychondritis, polyarteritis nodosa, giant-cell arteritis, Sweet's syndrome, ANCA-associated vasculitis, systemic lupus erythematosus, and adult-onset Still's disease. (nejm.org)
  • Female infants have two to three times' higher incidence for developing cardiac and cutaneous neonatal lupus erythematosus compared to male infants. (heraldopenaccess.us)
  • Other events with a possible relation to TNF-α-blocking therapy included vasculitis, psoriasis, drug-induced systemic lupus erythematosus, dermatomyositis, and a lymphomatoid-papulosis-like eruption. (biomedcentral.com)
  • These may include tests to check for inflammation, organ involvement, immune complex formation and deposition, and ANCA-related vasculitis. (cohencenters.com)
  • Cutaneous vasculopathy associated with levamisole-adulterated (contaminated) cocaine is an emerging syndrome characterised by a retiform purpura around the ears, the presence of anti- neutrophil cytoplasmic autoantibody ( ANCA ), and leukopenia [3,4]. (dermnetnz.org)
  • MPA and the clinically similar and similarly treated granulomatosis with polyangiitis ( GPA ) are classified as antineutrophil cytoplasmic autoantibody ( ANCA )-associated vasculitides ( AAV s). (empendium.com)
  • A positive myeloperoxidase ( MPO ) antineutrophil cytoplasmic antibody ( ANCA ) (type of perinuclear ANCA [ p-ANCA ], present in ~70% of patients) or proteinase 3 ( PR3 ) ANCA (type of cytoplasmic ANCA [ c-ANCA ], present in 45%) test result also suggests the diagnosis of microscopic polyangiitis. (empendium.com)
  • Granulomatosis with polyangiitis (Wegener's granulomatosis) is a type of vasculitis which can be categorized as a sub-branch of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides. (rheumres.org)
  • Granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis, is a type of vasculitis which can be categorized as a sub-branch of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides [1]. (rheumres.org)
  • The other differentials considered included rheumatoid neutrophilic dermatosis , rheumatoid vasculitis, non-specific ANCA positive vasculitis and atypical pyoderma gangrenosum. (edoj.org.eg)
  • Many cutaneous disorders experienced by patients undergoing dialysis have little to do with the uremic syndrome and are related to the same underlying pathologic process that caused the renal disease. (medscape.com)
  • Henoch-Schönlein purpura, granulomatosis with polyangiitis or GPA, eosinophilic granulomatosis with polyangiitis or EGPA, previously referred to as Churg-Strauss syndrome), cutaneous leukocytoclastic vasculitis, microscopic polyangiitis). (printo.it)
  • Disorders that present with pulmonary-renal syndrome, a combination of RPGN and DAH, include AAV, SLE, and Goodpasture's syndrome. (symptoma.com)
  • iii ) No other causes, such as bona fide vasculitis, primary anti-phospholidpids antibody syndrome or drugs, were accounted for clinical symptoms. (medicaljournals.se)
  • Numerous cytoplasmic vacuoles in erythroid and myeloid precursor cells are present in the bone marrow aspirate in almost all patients with VEXAS syndrome. (nejm.org)
  • We present a case of hypocomplementemic urticarial vasculitic syndrome (HUVS) who developed severe renal failure requiring ICU-level care. (hspioa.org)
  • Sweet syndrome manifests with extra-cutaneous features in up to 50% of cases. (eyewiki.org)
  • Patients usually present with tender, symmetrical palpable purpura on the lower limbs. (amboss.com)
  • Physical exam Palpable purpura is pathognomonic for vasculitis. (symptoma.com)
  • Microscopic polyangiitis ( MPA ) is a necrotizing vasculitis with few or no immunologic deposits, which usually affects small vessels (arterioles, capillaries, venules) and may involve small- and middle-sized arteries. (empendium.com)
  • Cutaneous necrotizing vasculitis is usually induced by an acute infection or exposure to a drug. (bgu.ac.il)
  • Some of the acute primary vasculitides are quite common paediatric diseases (e.g. (printo.it)
  • It accounts for approximately 10% of acute cutaneous vasculitis. (koreamed.org)
  • In patients with acute immunoglobulin A vasculitis, the administration of systemic corticosteroids reduces joint and abdominal pain but does not reduce the risk of nephritis. (aafp.org)
  • Vasculitis can be acute and short-term or chronic and long-term. (medicalnewstoday.com)
  • Some sufferers present with serious acute respiratory problems requiring mechanical venting [1, 4]. (angiogenesis-blog.com)
  • Accordingly, diagnosis of cutaneous vasculitis, identification of etiological factors, follow-up for systemic involvement and treatment are important. (bgu.ac.il)
  • A diagnosis of vasculitis limited to the skin requires a complete history and physical examination. (msdmanuals.com)
  • We present a concise review of the pathogenesis, classification, diagnosis and treatment update of this entity. (actasdermo.org)
  • A diagnosis of rheumatoid vasculitis should be questioned if the patient does not have severe seropositive RA of long-standing duration. (rheumaknowledgy.com)
  • Clinically, almost all panniculitides are present as vague, erythematous deep-seated nodules and a careful histopathological examination is required for appropriate diagnosis. (juniperpublishers.com)
  • In a large number of cases cutaneous vasculitis may present as an idiopathic condition and affect both small and medium sized vessels. (faoj.org)
  • arteritis risk if you don't treat temporal (giant cell) arteritis granulomatous vasculitis that involves aortic arch at branch points age group of takayasu arteritis younger than 50 - Asian females symptoms of takayasu arteritis 1. (symptoma.com)
  • The classification of vasculitides depends mainly on the size and type of blood vessels involved. (printo.it)
  • Rheumatoid vasculitis is inflammation of blood vessels in patients with RA . (rheumaknowledgy.com)
  • Vasculitis is defined as inflammation of the wall of blood vessels. (scielo.org.za)
  • Vasculitis means inflammation of the blood vessels. (medicalnewstoday.com)
  • Signs and symptoms of vasculitis vary depending on which blood vessels are affected, and which organs are damaged, if any. (medicalnewstoday.com)
  • Hypersensitivity vasculitis (allergic vasculitis). (wikipedia.org)
  • Hypersensitivity or allergy is present in some but not all cases. (lookformedical.com)
  • Any primary or secondary vasculitis can affect the skin, including that due to serum sickness, infections (eg, hepatitis C), cancers, rheumatologic or other autoimmune disorders, and hypersensitivity to drugs. (msdmanuals.com)
  • However, hypersensitivity vasculitis is sometimes used to refer to CSVV caused by a known drug or infection. (msdmanuals.com)
  • Another theory is that deposition of immune complexes within dermal vessels leads to vasculitis, a type III (Arthus type) hypersensitivity reaction. (clinicaladvisor.com)
  • ANCAs can be positive after the use of certain drugs and other forms of vasculitis can present with very similar symptoms. (checkorphan.org)
  • If skin involvement is secondary to a systemic vasculitis, symptoms may also include fever, arthralgias, other organ involvement, or a combination. (msdmanuals.com)
  • Widespread (systemic) vasculitis is usually accompanied by extensive release of inflammatory molecules, causing general symptoms like fever, malaise, as well as abnormal laboratory tests detecting inflammation: erythrocyte sedimentation rate (ESR) and C- reactive protein (CRP). (printo.it)
  • It is the purpose of this paper to present this case and to discuss some problems concerning genesis of symptoms of temporal arteritis. (symptoma.com)
  • Symptoms of vasculitis can include fever , tiredness , and joint pain. (medicalnewstoday.com)
  • Treatment for vasculitis depends on several factors, including what type of vasculitis the person has, the severity of their symptoms, their age, and their general health. (medicalnewstoday.com)
  • Physical examination showed deep tender subcutaneous nodules with overlying non-scale ill-defined erythema present over the right lateral inferior chest and right medial thigh (Figure 1). (juniperpublishers.com)
  • Detection of cytomegalovirus antigens in phagocytosed serum complexes from a patient with rheumatoid arthritis, vasculitis, peripheral neuropathy, cutaneous ulceration, and digital gangrene . (symptoma.com)
  • The purpose of this article is to integrate renal and cutaneous aspects of disease as well as highlight some important, although frequently underappreciated, clinical or laboratory findings that ally renal and skin diseases. (medscape.com)
  • The clinical and histological findings were consistent with cutaneous necrotizing leukocytoclastic vasculitis. (bgu.ac.il)
  • findings include leukocytoclastic vasculitis . (amboss.com)
  • The findings were reviewed by a pathologist at the University of Iowa Hospitals and Clinics and were found to be suggestive of leukocytoclastic vasculitis. (eyerounds.org)
  • 2,9 However, biopsies of affected skin generally do not demonstrate findings of vasculitis. (clinicaladvisor.com)
  • Others postulate that the skin findings are the result of cutaneous trauma caused by repeated, improperly performed injections, or that heparin may be poorly absorbed due to decreased vasculature in adipose tissue. (clinicaladvisor.com)
  • In this study, we present serial CT findings in. (koreamed.org)
  • 5 Disposition is variable and largely depends on the severity of vasculitis and resulting skin findings. (jetem.org)
  • Livedo reticularis, nodules, and deep ulcers are usually caused by vasculitis of deeper, medium or large vessels. (msdmanuals.com)
  • Cutaneous: Livedo reticularis, skin ulcers, tender erythematous nodules, bullous or vesicular eruptions, infarction and gangrene of fingers or toes, or a combination may occur. (symptoma.com)
  • Recent data suggest that oral lichenoid reactions (OLR) present a greater percentage of malignant transformation than oral lichen planus (OLP). (ecancer.org)
  • Livedo vasculopathy (LV) is a chronic cutaneous disorder characterised by recurrent, painful ulceration ending in stellate scars. (medicaljournals.se)
  • When using the influential classification known as the "Chapel Hill Consensus Conference", the terms "systemic vasculitis" or "primary systemic vasculitides" are commonly used. (wikipedia.org)
  • Beyond that, typical treatment plans are aimed at addressing the primary underlying disease associated with vasculitis. (cohencenters.com)
  • Vasculitis may be due to primary disease or secondary due to an underlying disorder, drug reaction, or infection. (faoj.org)
  • Primary systemic vasculitis is uncommon, accounting for only four percent of cases in patients with cutaneous vasculitis. (faoj.org)
  • Cutaneous vasculitis may be limited to the skin, or may be a component of a systemic primary or secondary vasculitic disorder. (msdmanuals.com)
  • Primary vasculitides do not usually run in the family. (printo.it)
  • The neonatal period is an uncommon time for the presentation of vasculitis and primary neonatal vasculitis is a particularly rare entity. (scielo.org.za)
  • Primary vasculitis has no known cause. (merckmanuals.com)
  • The clinical spectrum of primary renal vasculitis. (medscape.com)
  • Recent data suggest that OLR present a greater percentage of malignant transformation than OLP and, although the association between cancer and OLP has been documented in scientific reports, there is no association between squamous cell carcinoma and cutaneous lichen planus [ 4 - 6 ]. (ecancer.org)
  • One exception is a very recently described form of vasculitis, called "DADA2", but this is very rare. (printo.it)
  • Cutaneous examination of patients with ESRD has shown that 50-100% of patients have at least 1 dermatologic condition. (medscape.com)
  • A high prevalence of cutaneous disorders is expected, because most patients with ESRD have an underlying disease process with cutaneous manifestations. (medscape.com)
  • It has been reported that no identifiable cause is present in 3-72% of patients [1]. (faoj.org)
  • All patients manifesting rheumatoid vasculitis have strongly positive titers of IgM-RF. (rheumaknowledgy.com)
  • Skin eruptions may be a symptom of systemic disorders other than infections, and may be prominent in patients with vasculitis disorders. (scielo.org.za)
  • Of key interest is the effect of conventional synthetic (csDMARD) and biological/ targeted drugs (b/tsDMARDs) disease modifying antirheumatic drugs on the time of protection.ObjectivesTo compare antibody titer development in patients with vasculitis and connective tissue disease (CTD) with healthy controls 6 months after two mRNA vaccinations and after third immunization. (bvsalud.org)
  • Differences between two groups were calculated with Wilcoxon signed-rank test.ResultsA total of 53 patients with SARD (42 patients suffering from connective tissue disease and 11 with vasculitis respectively) and 73 HC were analysed. (bvsalud.org)
  • A: Antibody titers measured 6 months after two doses of mRNA vaccination in patients with connective tissue disease, vasculitis and healthy controls. (bvsalud.org)
  • The present study was set up to investigate the number and nature of clinically important dermatological conditions during TNF-α-blocking therapy in patients with rheumatoid arthritis (RA). (biomedcentral.com)
  • In addition, uremia and conditions associated with renal replacement therapy are fraught with numerous and, often, relatively unique cutaneous disorders. (medscape.com)
  • The image below illustrates several uremia-related cutaneous disorders. (medscape.com)
  • Several uremia-related cutaneous disorders are visible. (medscape.com)
  • These systemic disorders and the associated renal diseases and cutaneous manifestations are tabulated in Table 1, below. (medscape.com)
  • Intraepidermal injections of autologous epidermal cell suspension can be a new and very promising treatment for many other cutaneous disorders as non-scarring alopecia (Alopecia Areata, Androgenic Alopecia) or scarring alopecia (Lichern Plano Pilaris alopecia, Discoid Lupus Erithematosus alopecia), anti-aging therapies. (hspioa.org)
  • Cutaneous vasculitis may precede severe systemic involvement, and may end in death. (bgu.ac.il)
  • In this review, cases are divided between localised disease, non-organ threatening, generalized organ-threatening disease and severe kidney vasculitis and immediately life-threatening disease. (checkorphan.org)
  • Systemic vasculitis complicating lupus will often present with severe skin rashes which may be necrotic leading to gangrene . (symptoma.com)
  • Vasculitides include a wide group of diseases. (printo.it)
  • Vasculitis has a number of potential causes including infections and immunologic diseases. (medicalnewstoday.com)
  • There are many forms of vasculitis, ranging from mild to potentially life-threatening. (printo.it)
  • Cutaneous vasculitis may present with varying clinical manifestations and may be caused by systemic disease or secondarily due to an underlying disorder, drug reaction, or infection [1-2]. (faoj.org)
  • Clinical, histopathologic, and laboratory evaluation are imperative to appropriately diagnose cutaneous vasculitis. (faoj.org)
  • Lung involvement can present as diffuse alveolar hemorrhage. (empendium.com)
  • Instances of upper respiratory tract, lower respiratory tract, and kidney involvement are less common in the present study than in most other studies. (rheumres.org)
  • Vasculitis is a rare disorder during the neonatal period. (scielo.org.za)
  • Secondary vasculitis may be triggered by an infection, a drug, or a toxin or may occur as part of another inflammatory disorder or cancer. (merckmanuals.com)
  • We characterize the role of increased Lyn kinase activity in neutrophils, endothelial cells and lesional liver biopsies and utilized an iPSC-derived endothelial cell platform for disease modeling of neutrophilic vasculitis and to screen and evaluate drug efficacy. (nature.com)
  • Chronic vasculitis of both large and medium vessels, primarily affecting cranial branches of the arteries arising from the aortic arch. (wikipedia.org)
  • Neonatal lupus syndromes (NLS) occurs in infants born to mother with rheumatic conditions including systemic lupus erythematous (SLE), Sjögren's disease, mixed connective tissue disease, leukocytoclastic vasculitis, various forms of arthritis, immune-mediated thrombocytopenia, thyroiditis, autoimmune hepatitis, and undifferentiated autoimmune syndromes. (heraldopenaccess.us)