NOVA KLASIFIKACIJA VASKULITISA

Branimir Anić

Sindrom vaskulitisa obuhvaća heterogenu skupinu upalnih reumatskih bolesti kojima je zajedničko obilježje upala u stijenci krvne žile. Postavljanje dijagnoze vaskulitisa jedan je od najvećih izazova u medicini. Klinička slika vaskulitisa ovisi o opsegu zahvaćanja pojedinog organa ili organskog sustava kao i o ukupnom broju zahvaćenih organa. Veliki raspon kliničkih očitovanja vaskulitisa te niska incidencija bolesti otežavaju sustavno kliničko istraživanje vaskulitisa. Potrebe kliničke rutine kao i potreba provođenja sustavnih kliničkih istraživanja nameću potrebu jasnog razlikovanja pojedinih kliničkih entiteta. Predlagane su različite podjele vaskulitičnih sindroma: prema etiologiji, patogenezi, histološkom nalazu u zahvaćenim žilama, zahvaćenosti pojedinih organa i organskih sustava. U tekstu su kratko prikazane i komentirane novosti te recentne podjele i nomenklatura vaskulitičnih entiteta predloženi na drugoj konferenciji u Chapel Hillu.

Vasculitis syndrome comprises a heterogenic group of inflammatory rheumatic diseases whose common feature is inflammation in the blood vessel wall. Establishing the diagnosis of vasculitis is one of the greatest challenges in medicine. Clinical presentation of vasculitis depends on the extent of an organ system affection, as well as on the total number of affected organs. A great range of clinical presentations of vasculitis and the low incidence of the disease impede systematic clinical investigation of vasculitis. The needs of clinical routine and the need for conducting systemic clinical investigations require a clear distinction of individual clinical entities. Different classifications of vasculitis syndrome have been proposed: according to etiology, pathogenesis, histological finding in the affected vessels, affection of individual organs and organ systems. This paper presents and comments news and recent classifications and nomenclature of vasculitic entities proposed at the second conference in Chapel Hill.