Vasculitides: Classification

According to the 2012 Chapel Hill Consensus Conference, vasculitides are classified as follows.

I Vasculitis of the small vessels (small-vessel vasculitides)
ANCA-associated vasculitides (AAV).
1 Granulomatosis with polyangiitis (GPA)[formerly: Wegener’s granulomatosis].
2 Eosinophilic granulomatosis with polyangiitis (EGPA)[formerly: Churg-Strauss syndrome (CSS)]
3 Microscopic polyangiitis (MPA)
Non-ANCA associated
4 Anti-GBM disease[formerly: Goodpasture’s syndrome].
5 Schönlein-Henoch purpura[new: IgA vasculitis (IgAV)]
6 Cryoglobulinemic vasculitis (CV) (vasculitis associated with essential cryoglobulinemia).
7 Hypocomplementemic urticarial vasculitis (HUV, anti-C1q vasculitis).
II Vasculitis of medium-sized vessels (vasculitides of medium-sized vessels)
1 Classic panarteritis
2 Kawasaki disease (MCLS; Kawasaki syndrome)
III Large vessel vasculitis (large vessel vasculitides)
1 Giant cell arteritis
2 Takayasu arteritis
IV Vasculitis of variable vessel size
Behçet’s disease
Cogan syndrome
V Single-organ vasculitis
Cutaneous leukocytoclastic angiitis
Cutaneous arteritis
More
VI Systemic vasculitis
Lupus vasculitis
Rheumatoid vasculitis
More
VII Secondary vasculitis
Hepatitis C-associated
Hepatitis B-associated
Drug-associated
Tumor-associated

Activity stages of ANCA-associated vasculitides (AAV) – EUVAS definition.

Activity stage Definition
Localized stage Upper and/or lower respiratory tract without systemic manifestation, without B symptoms, not organ-threatening1
Early systemic stage All organ involvement possible, not life-threatening or organ-threatening2
Generalization stage Renal involvement (kidney involvement) or other organ-threatening manifestation (serum creatinine < 500 µmol/l (5.6 mg/dl))3
Severe, vital-threatening generalization stage Renal failure or other organ failure (creatinine > 500 µmol/l (5.6 mg/dl))3
Refractory stage Progressive disease, refractory to standard therapy (glucocorticoids, cyclophosphamide)

Legend

  • 1ANCA often negative
  • 2ANCA negative or positive
  • 3ANCA almost always positive

B symptomatology

  • Unexplained, persistent or recurrent fever (> 38 °C).
  • Night sweats (wet hair, soaked sleepwear).
  • Unwanted weight loss (> 10% percent of body weight within 6 months).

Granulomatosis with polyangiitis (GPA), formerly Wegener’s granulomatosis, and eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg-Strauss syndrome (CSS), can also be classified according to ACR criteria* (see under the corresponding disease).