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Watching out for syndromes that mimic vasculitis

One presenter at the 2019 Rheumatology Nurses Society Annual Conference, the president of the Independent Healthcare Associates, has warned that rheumatologists must beware when diagnosing patients who might have vasculitis. Vasculitis refers to the inflammation of the blood vessels. The problem is that various syndromes can result in this, raising the risk for misdiagnosis. New Jersey residents will want to know what can be done.

Rheumatologists must first know what the vasculitis mimics are. Endocarditis, or the infection of the heart’s inner lining, is one classic example. For many adults, vasculitis may be the result of cocaine or amphetamine use, so doctors must remember to consider this before saying that the cause is idiopathic vasculitis.

Vasculitis may also be a cholesterol embolism, in which case an ophthalmologist should be brought in to check the retina. A rare condition that mimics vasculitis is reversible cerebral vasoconstriction syndrome, characterized by a tightening of the blood vessels leading to the brain.

A vasculitis misdiagnosis can have serious consequences. Vasculitis mimics can worsen when patients take the glucocorticoids that are used to treat real vasculitis. In one case, a rheumatologist had a patient suspected of having rheumatoid arthritis but did not order blood cultures or consider the fever the patient was running. The patient really had endocarditis, which led to her suffering a stroke.

Those who are injured as an indirect result of misdiagnosis and who believe the error was due to negligence may have a case under medical malpractice law. Patients may not want to pursue such a case alone, though, because it takes special knowledge to prove negligence and determine the extent of economic and non-economic damages. A lawyer may help by evaluating the case and hiring third parties to investigate the situation. He or she may be able to negotiate for a settlement.