What is included in the long-term monitoring of vasculitis?

Updated: Dec 10, 2018
  • Author: Nadia Jennifer Chiara Luca, MD; Chief Editor: Lawrence K Jung, MD  more...
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Answer

Close follow-up of patients with systemic vasculitis by a multidisciplinary team is extremely important for monitoring progression of disease, response to therapy, and complications.

Patients with Henoch-Schönlein purpura should have periodic checks of urinalysis as long as 6 months after the acute illness to screen for delayed-onset nephritis. [21]

Patients with Kawasaki disease should have follow-up with echocardiogram at 6-8 weeks after acute illness. Most centers are also doing follow-up echocardiogram at 1 year.

Patients receiving cyclophosphamide should have close monitoring of CBC count for cytopenias.

Patients receiving rituximab should have regular monitoring of immunoglobulin levels and CD19+ lymphocyte count.

For patients with elevated antineutrophil cytoplasmic antibody (ANCA), titers may normalize during periods of disease control and increase with disease activity. Serial ANCA titers have been used to measure disease activity, with limited success. An acute rise in ANCA titer suggests clinical activity; persistent high titers are less helpful in identifying patients with active disease.


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