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Drug induced small vessel vasculitis

Drug Induced Small Vessel Vasculitis 289 ANCA are found also in other conditions, where its role it is not well understood (DeBant et al, 2005), for example: Ulcerative Colitis, Crohn s disease and HIV (Doyle & Cuellar, 2003; Mekel PA, 2001). 3. Historical evolutio Drug-Induced Vasculitis Drug-induced vasculitis usually develops within seven to 21 days after a drug is started and may be confined to the skin. 3 Skin lesions are identical to those seen in.. Vasculitis may be caused by infection, medications, systemic diseases, malignancy, or occur as an idiopathic condition. In cases of drug-induced vasculitis, it is essential to identify and discontinue the culprit medication

Among the secondary causes, drug induced vasculitis deserves special mention as resolution of vasculitis is likely to occur after withdrawal of the offending agent.27Patients could present with a wide range of manifestations ranging from isolated cutaneous vasculitis to widespread internal organ involvement Systemic vasculitis occurs in a heterogeneous group of primary disorders or can be a manifestation of infection, an adverse drug reaction, malignancy or a connective tissue disease

The most common drugs that cause LCV are antibiotics, particularly beta-lactam drugs, nonsteroidal anti-inflammatory drugs, and diuretics. However, almost all drugs are potential causes Vasculitis may be associated with infection, immunization or anti-microbial drugs. Infections are responsible for a number of different types of vasculitis. Conversely, patients with vasculitis may develop infections, which sometimes mimic relapse

ANCA-Associated Small-Vessel Vasculitis - American Family

Patients Sixty-three patients with cutaneous small-vessel vasculitis meeting specific inclusion criteria were divided into drug-induced (n = 16) and non-drug-induced (n = 47) groups. Main Outcome Measures Corresponding histopathologic material was reviewed by a dermatopathologist masked to the etiologic associations Names often used interchangeably but not always accurately, have included hypersensitivity angiitis, drug-induced vasculitis, leukocytoclastic vasculitis, cutaneous leukocytoclastic angiitis, serum sickness, serum sickness-like reactions, and allergic vasculitis Cyclophosphamide is a tried-and-true older drug, taken orally or intravenously, that doctors also use to treat cancer. It is currently given mainly in the setting of severe small- and medium-vessel vasculitis Hypersensitivity vasculitis is commonly triggered by a reaction to a drug. Common drugs linked to hypersensitivity vasculitis include: certain antibiotics such as penicillin and sulfa drugs The ICD-10-CM code L95.8 might also be used to specify conditions or terms like cutaneous gonorrhea, drug-induced lymphocytic vasculitis, eosinophilic vasculitis of skin, erythema induratum, familial pigmented purpuric eruption, gonococcal bacteremia-induced pustular vasculitis, etc

Pupura In A Patient With LupusDrug-induced lupus erythematosus | DermNet NZ

amphetamines, in whom vasculitis was attributed to the amphetamines.45 Only two published cases with biopsies verified that small-vessel vasculitis existed in patients with cocaine abuse who had no history of concomitant drug use.3 Our patient presented with multifocal ischemia shortly after using intravenous and inhaled cocaine Small-vessel vasculitis Drug-induced small-vessel involvement may result in cutaneous vasculitis alone or also involve internal organs such as the kidney and peripheral nerves. A typical feature of small-vessel vasculitis (SVV) induced by drugs is the presence of antineutrophil cytoplasmic antibodies (ANCA) in a significant proportion, which may have specificity toward proteinase-3 (anti-PR3. Systemic small vessel vasculitis can either be a secondary phenomenon of another disease or constitute a specific primary disease entity. Autoantibodies are common in small vessel vasculitis, and in primary small vessel vasculitis they are preferentially directed against components of the immune system

The term vasculitis includes a heterogeneous group of multisystemic disorders characterized pathologically by inflammation of blood vessels [1,2,3]. Inflammation can involve some, or all, of the thickness of the vessel wall. Immune complexes are a major component of vasculitis syndromes, and cellular mechanisms play a major pathogenic rol Similarly, small vessel vasculitis doesn't always involve neutrophils. It may include other immune cells like lymphocytes and granulomas. The condition can affect the small blood vessels of any.

Although drugs are the most common cause, drug-induced vasculitis is a poorly defined disorder. The drugs that are most frequently listed as being associated with the development of HV include: penicillin, cephalosporin, sulfonamide, some medicines used to control blood pressure (loop and thiazide-type diuretics), phenytoin and allopurinol Drug-induced small vessel vasculitis develops within 1 to 3 weeks after the use of certain pharmaceutical preparations, including penicillin, thiazides and sulfonamides. The implicated drugs cause. Primary cutaneous small-vessel vasculitis: approach to diagnosis and treatment. Int J Dermatol. vol. 45. 2006. pp. 3-13. (A review of primarily cutaneous leukocytoclastic vasculitis where no systemic disease is associated. Evaluations starting with simpler, broader and cost-effective tests are presented and tabulated Cutaneous vasculitis is a group of disorders in which there are inflamed blood vessels in the skin. These may include capillaries, venules, arterioles and lymphatics. Cutaneous vasculitis has several different causes. There are a wide variety of clinical presentations. It is associated with systemic vasculitis in a minority of patients Exercise-induced vasculitis. Is a small vessel vasculitis that affects one or both lower legs following strenuous exercise such as long-distance running and hiking. Symptoms are worse in warm weather. Is more common in women, and patients aged over 50 years

The incidence of hypersensitivity vasculitis is unknown, but the condition is presumed to be relatively rare. A 2014 population-based study in Minnesota found the incidence of cutaneous leukocytoclastic vasculitis in adults (including IgA vasculitis as well as other types of small-vessel vasculitis) to be at 45 cases per million Retinal vasculitis can be an isolated condition or a complication of local or systemic inflammatory disorders characterized by inflammation of the retinal vessels. It is a sight-threatening condition associated with various infective, auto-immune, inflammatory or neoplastic disorders Many drugs are associated with development of small-vessel lung vasculitis . 20. 78. and 79. Drug-induced vasculitis may be an expression of a type III (immune complex) or a type IV (cell-mediated) hypersensitivity response. Pulmonary involvement is usually associated with, and often overshadowed by, systemic vasculitis that particularly. Drug Induced Small Vessel Vasculitis, Advances in the Etiology, Pathogenesis and Pathology of Vasculitis, Luis M. Amezcua-Guerra, IntechOpen, DOI: 10.5772/21388. Available from: Over 21,000 IntechOpen readers like this topic. Help us write another book on this subject and reach those readers.

Severe Small-Vessel Vasculitis Temporally Associated With

Introduction. Vasculitis is defined as the inflammation of blood vessels, which can result in loss of blood vessel integrity leading to downstream tissue ischemia and necrosis ().Diagnosis of drug-induced vasculitis (DV) is largely based on the temporal relation of drug administration and symptom onset after the exclusion of other possible etiologies along with the resolution of symptoms after. drug-induced lupus have been postulated as a continuum of drug-induced autoimmune disorders especially with hydralazine (14). Review by Yokogawa et al., concluded overlapping clinicopathologic features of hydralazine induced lupus and vasculitis, with vasculitis cases tend to have a more severe clinical course requiring aggressive treatment (15) Drug-induced Vasculitis. Antibiotics, chemotherapy, and illegal addictive drugs (cocaine, heroin) can cause a vasculitis that affects medium-sized arteries and results in infarctions. MR imaging patterns in drug-induced vasculitis are inconsistent and depend on the vessels involved

Drug-Induced vasculitis — University of Texas Southwestern

Finally, one should keep in mind that the vast majority of drug-induced small-vessel vasculitis falls into the category of cutaneous leukocytoclastic angiitis (hypersensitivity vasculitis) or IgA vasculitis (Henoch-Schönlein purpura). Table 26.3. Agents commonly reported. Medication. Minocycline. Famciclovir. Carbamazepine Drug-induced vasculitis is an inflammation of blood vessels caused by the use of various pharmaceutical agents. Vasculitis causes changes in the walls of blood vessels, including thickening, weakening, narrowing and scarring. Inflammation can be short-term (acute) or long-term (chronic) and can be so severe that the tissues and organs supplied by the affected vessels do not get enough blood Drug-induced vasculitis is defined as inflammation of blood vessels due to an adverse effect of a drug. Histologically, vasculitis is defined as an inflammatory cell-mediated infiltration and destruction of blood vessels. Vasculitis can be either primary, as seen in granulomatous polyangiits, or secondary, when associated with drugs, infection.

Cutaneous small vessel vasculitis DermNet N

  1. The small-vessel ANCA-type vasculitis is the most common cause of crescentic glomerulonephritis, particularly in those over 60 years of age. Most cases are idiopathic, while some have been associated with the use of drugs, particularly the antithyroid agent propylthiouracil and the antihypertensive drug hydralazine. 74 Most drug-induced cases.
  2. Drug-induced skin reactions are common, but only a small portion (10%) are attributed to a vasculitic mechanism. Small-vessel vasculitis (SVV) with leukocytoclastic histopathology is usually described in drug-induced vasculitis; however, given the shared histopathologic features between drug-induced vasculitis and other SVV, it is crucial to rule out infectious or other autoimmune etiologies.
  3. Although cutaneous small-vessel vasculitis is not rare, few epidemiological studies and no large controlled therapeutic trials have been conducted. Short courses of systemic glucocorticoids can be prescribed for severe flares of cutaneous disease (prednisone, 0.5 to 1 mg/kg/day for 1 week, followed by a rapid tapering over 2-3 weeks)
  4. Drug-induced small vessel vasculitis develops within 1 to 3 weeks after the use of certain pharmaceutical preparations, including penicillin, thiazides and sulfonamides. The implicated drugs cause lesions that may be confined to the skin. Treatment of ANCA-associated small vessel vasculitides

Drug-induced small vessel vasculitis is thought to be mediated by immune complex deposition. 15 Circulating antigens in the body [induced by medications] induce antibody formation. These antibodies bind to the circulating antigen and create immune complexes, which are then deposited within vessels, activating complement and inducing. Types of small vessel vasculitis. ANCA-associated small vessel vasculitis is the more common of the two. This category includes: Microscopic polyangiitis (MPA) Churg-Strauss syndrome (CSS) Wegener's granulomatosis (WG) Drug-induced small vessel inflammation. Non-ANCA small vessel vasculitides include: Vasculitis associated with paraneoplastic. Drug-Induced Vasculitis. Drug-induced vasculitis usually develops within seven to 21 days after a drug is started and may be confined to the skin 34). Skin lesions are identical to those seen in systemic small vessel vasculitis. Drugs cause approximately 10 percent of vasculitic skin lesions Main consideration is what form of vasculitis is present. Requires careful pathologic analysis and clinical correlation. Crohn's disease or ulcerative colitis : Severe cases of inflammatory bowel disease may show focal inflammation of vessels as part of the overall inflammatory component. True vasculitis may rarely coexist ( Semin Arthritis. Localized vasculitis, nonnecrotizing, involving vessels larger than capillaries: granuloma faciale, erythema elevatum diutinum and localized, chronic fibrosing vasculitis Lymphocytic, nonnecrotizing vasculitis of small, superficial vessels: bilateral nonblanching purpuric and pigmented macules on ankles and lower legs; due to drug eruption,.

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The emergence of rituximab during the past decade as a new therapy for ANCA-associated vasculitis (AAV) has been the most important innovation in this disease area since cyclophosphamide 40 years ago. The article by Niles et al. (1) in this issue of CJASN adds to the evidence of its efficacy. For nephrologists, vasculitis usually means a necrotizing, crescentic glomerulonephritis associated. I interacted with you about 3 weeks ago. You suggested Shramburgs but I am thinking drug induced small vessel vasculitis because of the sudden onset after the admin of Gabapentin (you offered that too.

Severe small-vessel vasculitis may cause small microinfarcts of the tips of the digits, which heal with ice pick scars (Fig. 5). Infrequently, vasculitis may manifest as urticaria (5-10%) [60-62] and requires differentiation from allergic urticaria. The lesions may be hyperpathic to light touch, persist for more than 24 h, and may. Medium Vessel Vasculitis . Small Vessel Vasculitis . Miscellaneous Disorders . Superior Mesenteric Artery Dissection . Trauma . Radiation Enteritis . Splanchnic Artery Aneurysms . Drug-Induced Small Bowel Angioedema . Median Arcuate Ligament Syndrome . Hemangiomas . Summary . Small bowel abnormalities continue to be a significant diagnostic.

Diagnostic approach to patients with suspected vasculiti

  1. Leukocytoclastic vasculitis may be caused by a specific drug or occur in association with an infection, but it may also be idiopathic, meaning there is no known cause. Although drugs are the most common cause, drug-induced vasculitis is a poorly defined disorder
  2. Based on the size of the vessel affected, it can be classified into small-vessel, medium-vessel, or large-vessel vasculitis. While the inflammatory process may be confined to one organ, it may also involve several organ systems
  3. Anti-GBM disease is a rare form of vasculitis. It causes damage to small blood vessels in the kidneys and lungs. Diagnosis is confirmed by detecting anti-GBM antibodies in blood or deposited in the kidney. Treatment with plasma exchange (to remove anti-GBM antibodies) together with prednisolone and cyclophosphamide is usually successful
  4. Central nervous system (CNS) vasculitides represent a heterogeneous group of inflammatory diseases affecting the walls of blood vessels in the brain, spinal cord, and the meninges.. Please refer to the article on vasculitis for a general discussion of that entity.. The aim of this article will be to discuss the primary angiitis of the CNS (PACNS) since the other vasculitides are already.
  5. Medium vessel Vasculitis• Poly Arteritis Nodosa• Kawasaki's vasculitis 22. Small vessel VasculitisPauci-immune (ANCA mediated) Wegener's Granulomatosis Churg Strauss vasculitis Microscopic PolyangiitisImmune complex mediated Henoch Schonlein Purpura Essential Mixed Cryoglobulinemia SLE and other collagen c=vascular diseasesrelated vasculti
  6. Drug-induced small vessel vasculitis usually attacks the skin or subcutaneous parts of the skin. In cancer therapy, there have been case reports that hormonal drugs such as estrogen receptor antagonists, aromatase inhibitors, and epidermal growth factor receptor (EGFR) inhibitors can induce cutaneous vasculitis

Drug-induced autoimmune disease was initially described decades ago, with reports of vasculitis and a lupus-like syndrome in patients taking hydralazine, procainamide, and sulfadiazine. Over the years, multiple other agents have been linked to immune-mediated glomerular disease, often with associated autoantibody formation. Certain clinical and laboratory features may distinguish these. Paraneoplastic small-vessel vasculitis Henoch-Schonlein Cryoglobulinemia vasculitis Lupus vasculitis Rheumatoid arthritis Goodpasture's Sjogren's Drug-induced immune-complex vasculitis Behcet's Infection induced immune complex vasculitis IBD vasculitis. Small vessel vasculitis (Non-ANCA associated)? Giant cell arteritis Takayasu's Vasculitis means inflammation of blood vessels. The inflammation can be short term (acute) or long term (chronic), and it can be so severe that it reduces blood flow to tissues and organs. This can cause dangerous organ and tissue damage, especially when vasculitis affects blood vessels in the brain, lungs, kidneys or other vital areas

An Approach to Diagnosis and Initial Management of

  1. Vasculitis is a term referring to inflammation of blood vessels; these may be arteries, veins or both, and can affect any part of the body. When vasculitis affects small or medium sized blood vessels in the skin, it is known as cutaneous vasculitis
  2. Published by Primary Care Dermatology Society (PCDS), 08 June 2021. Vasculitis refers to the inflammation and necrosis of blood vessels, and may be localised or systemic. Many of the vasculitides (conditions associated with vasculitis) have a cutaneous component. Read Summary
  3. Drug-induced small vessel vasculitis is mediated by immune complex deposition. These medications can induce the production of antigens which lead to the formation of antibodies; these immune complexes are deposited within vessels, resulting in complement activation and the inflammatory process [12]
  4. al pain and nausea
  5. Vasculitis is a term referring to inflammation of blood vessels; these may be arteries, veins or both, and can affect any part of the body. When vasculitis affects small or medium sized blood vessels in the skin, it is known as cutaneous vasculitis. Occasionally cutaneous vasculitis can be a sign of inflammation occurring in other organs (a.
  6. The Brain. Vasculitis affecting the central nervous system affects less than 7% of people with lupus and is perhaps the most serious complication related to lupus. 4  Central nervous system symptoms in lupus can be related to vasculitis or can be the direct result of autoantibodies against other tissues in the brain
  7. of Gabapentin (you offered that too View answe

What are the most common drugs that cause leukocytoclastic

  1. ority develop clinical vasculitis. Pulmonary-renal syndrome (PRS) occurs very rarely in drug induced vasculitis, but requires prompt recognition and treatment to avoid fatal complications. We present a case of PTU-induced small vessel vasculitis causing pulmonary-renal syndrome
  2. Polymorphonuclear leukocytes then migrate to the area and release lysosonial enzymes, which damage or destroy blood vessels.' Eosinophils often form part of the inflammatory infil- International Journal of Dermatology Vol. 32, No. 7, July 1993 trate in drug-induced small vessel vasculitis
  3. Endothelial cells are also likely to be the target in drug-induced small vessel vasculitis. Toxicity to podocytes accounts for focal segmental glomerulosclerosis caused by pamidronate and other agents. Chloroquine can cause a remarkable pseudo-storage disorder with inclusions in podocytes that resemble those seen in Fabry disease. The mechanism.

Segmental small bowel mural stratification can be seen with small-vessel vasculitis, small-vessel ischemia, chemotherapy-induced enteritis, and radiation therapy. ACE inhibitor-induced angioedema should be considered if these conditions are excluded and there is an appropriate clinical history The process of inflammatory damage to and the destruction of blood vessels is called vasculitis. LCV, also known as hypersensitivity vasculitis, is a small-vessel vasculitis characterized by leukocyte infiltration, inflammation, and necrosis of vessel walls. 1 The etiologies of LCV include infection, autoimmune disease, malignancy and medication. 5 Drug-induced vasculitis Drug-induced small vessel vasculitis is usually confined to the skin, but systemic involvement should also be excluded. Causative drugs include penicillins, sulfonamides, NSAIDS and thiazides. Onset is usually within 1 to 3 weeks of taking the drug. Brown plaques with vesicles and erythematous ri

Cases presented: Leucocytoclastic vasculitis and drug induced vasculitis. Case 1: Leucocytoclastic Vasculitis . Leukocytoclastic vasculitis (LCV), also known as hypersensitivity vasculitis, typically involves inflammation of small-vessel and palpable purpuras (red or purple discoloration of skin) measuring 1-3 mm Isotretinoin Induced Small Vessel Vasculitis: A Life Threatening Complication S. Annangi , K. Donaldson , and S. Pasha Paclitaxel-Induced Acute Bilateral Pneumoniti

Diagnosis of small vessel vasculitis . Premium Questions. What is the cure for vasculitis ? MD. You suggested Shramburgs but I am thinking drug induced small vessel vasculitis because of the sudden onset after the admin of Gabapentin (you offered that too View answer drug induced small vessel vasculitis. palpable purpura, associated w/ PCN, NSAIDs, sulfonamides, cephalosporins. Warfarin-induced skin necrosis. acquired protein C dysfunction (caused by starting it w/o heparin, vit K sensitive factors (abnl carboxylation)-->2-5d-->drop in protein C fx-->clot excessively)--> fatty areas (breast, hips, buttocks. The development of cutaneous small-vessel vasculitis can be drug induced or secondary to infection. damage secondary to heightened immune responses against viral antigen deposition is a recently postulated mechanism of small vessel vasculitis in conjunction with COVID-19 infection.2 The current hypothesis involves increased angiotensin II.

Infection and vasculitis Rheumatology Oxford Academi

Background: Antineutrophil cytoplasmic antibodies (ANCAs) are the serologic hallmark of ANCA-associated primary small-vessel vasculitides (AAVs), but these antibodies have also been described in other autoimmune diseases such as inflammatory bowel diseases. Furthermore, different drugs are linked to the induction of ANCA, including propylthiouracil (PTU) Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a small- to medium-vessel necrotizing vasculitis responsible for excess morbidity and mortality (1). The AAVs, which include granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA), are among the most difficult types of vasculitis to treat 5 Drug-induced vasculitis Drug-induced small vessel vasculitis is usually confined to the skin, but systemic involvement should also be excluded. Causative drugs include penicillins, sulfonamides, NSAIDS and thiazides. Onset is usually within 1 to 3 weeks of taking the drug. Intense erythema and erythematous papules ove

Keywords: Graves' disease, Propylthiouracil, Anti-neutrophil cytoplasmic antibodies, Drug-induced, Small vessel vasculitis Background Antineutrophil cytoplasmic antibodies (ANCAs) are the serologic hallmark of ANCA-associated primary small-vessel vasculitides, with myeloperoxidase (MPO) and proteinase 3 (PR3) being identified as the tw Lymphocytic vasculitis is one of several skin conditions which are collectively referred to as cutaneous vasculitis. In lymphocytic vasculitis, white blood cells (lymphocytes) cause damage to blood vessels in the skin. This condition is thought to be caused by a number of factors, but the exact cause of most cases is not known

Drug-induced small vessel vasculitis (hypersensitivity vasculitis) Immunopaedia.org.za Examination Vitals Heart rate: 83/min Blood pressure: 114/72 mmHg Temperature: 37.8°C Oxygen saturation: 97% General He looks tired No pallor Livedo reticularis (mottled reticulated vascular pattern that appears as a lace-like purplis Drug-induced small vessel vasculitis (or hypersensitivity vasculitis) is rarer. This is generally limited to the skin, but can occur as an element of a systemic illness. The rash is purpuric, palpable and occurs in dependent areas. Biopsies show a cellular infiltrate of small vessels often with leucocytoclasis The viruses associated with human vasculitis are surprisingly diverse. Hepatitis B virus (HBV) is associated with two types of vasculitis: cryoglobulinemic small-vessel vasculitis and PAN. Immune complex (IC)-mediated small-vessel vasculitis is reported in approximately 10% of patients with HBV infection

Tissue Eosinophilia as an Indicator of Drug-Induced

ABSTRACT: Small-vessel vasculitis syndromes associated with the presence of antineutrophil cytoplasmic antibodies (ANCA) can present in older patients with systemic symptoms, including weakness, fatigue, neuropathy, lung disease, and renal failure. The authors review types of ANCA-associated vasculitides, with a focus on eosinophilic granulomatosis with polyangiitis and their clinical. to the skin. The development of cutaneous small- vessel vasculitis can be drug induced or secondary to infection. Vascular damage secondary to heightened immune responses against viral antigen deposition is a recently postulated mechanism of small vessel vasculitis in conjunction with COVID-19 infec-tion.2 The current hypothesis involves increase He was diagnosed with drug-induced small-vessel vasculitis. He subsequently received ticlopidine with no further complications.Author CommentThe authors established a diagnosis of vasculitis secondary to acenocoumarol in view of the chronological relationship between suspending the drug and the clearing of the signs of vasculitis,.

Vasculitis Affecting Small Blood Vessels: ANCA-AssociatedANCA Vasculitis & ANCA Associated Vasculitis SymptomsMedicine by Sfakianakis G

Churg-Strauss syndrome is a disorder marked by blood vessel inflammation. This inflammation can restrict blood flow to organs and tissues, sometimes permanently damaging them. This condition is also known as eosinophilic granulomatosis with polyangiitis (EGPA). Asthma is the most common sign of Churg-Strauss syndrome however, small vessel vasculitis (SVV) with pulmonary and renal involvement is rare. We present the case of an 81-year-old woman on PTU treatment due to toxic nodular goitre who deve-loped alveolar hemorrhage and rapidly progressive glomerulonephritis. The authors highlight the importance of early reco-gnising drug-induced pulmonary-renal syndrom Hydralazine-induced small vessel vasculitis has a characteristic pattern of acral pseudoembolic vesiculopustules with necrosis and ulceration, along with involvement of the aerodigestive tract. • Unlike systemic lupus erythematosus (SLE), hydralazine-induced vasculitis is associated with positiv He was diagnosed with drug- induced small-vessel vasculitis. He subsequently received ticlopidine with no further complications. Author comment: The authors established a diagnosis of vasculitis secondary to acenocoumarol in view of the chronological relationship between suspending the drug and the clearing of the signs of vasculitis, and the. great toe with drug induced small vessel vasculitis was provisionally made. Relevant investigations to evaluate her diabetes control and gan-grene were advised. Her random glucose level were 383mg/dl and Eryth - rocyte Sedimentation Rate (ESR) was 130mm/hr. Her left lower limb arterial doppler was done and the impression was generalized athero