Rheumatologists to look out for vasculitis mimics

Rheumatologists in Kentucky and across the U.S. often meet patients with what seems like vasculitis: that is, an inflammation of the blood vessels. However, there are many conditions that mimic vasculitis, so a high degree of suspicion is necessary. This was the statement of one of the presenters at the 2019 Rheumatology Nurses Society Conference.

The presenter, president of the Independent Healthcare Associates, says that misdiagnosing vasculitis can lead to injury. In one case, a rheumatologist had a patient with what was suspected to be rheumatoid arthritis, but the doctor disregarded the patient's fever and did not order blood cultures. It turns out that the patient had endocarditis, an infection of the heart's inner lining, and a classic example of a vasculitis mimic. The patient suffered a stroke afterwards and became permanently disabled.

Another thing to remember is that among adults, vasculitis can be caused by drug use. Cocaine and amphetamine use are known to cause vasculitis-like symptoms. Cholesterol embolisms are a third example of a vasculitis mimic, so doctors should not hesitate to have an ophthalmologist check the retina for signs of retinal disease.

A last condition, much rarer, that mimics vasculitis is reversible cerebral vasoconstriction syndrome. It affects the blood vessels leading to the brain and is characterized by thunderclap headaches.

Many doctors misdiagnose a condition through their own negligence. When the error leads to unnecessary treatments, a decreased survival rate and other negative consequences, the victim may be able to file a claim under medical malpractice law and be compensated for the medical costs, pain and suffering, lost wages and other related losses. They may want a lawyer by their side, though, because it takes a lot to prove malpractice and link it to the injuries. The lawyer may speak at the negotiation table and even in the courtroom.

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