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Rheumatologists must watch out for vasculitis mimics

There are several syndromes that mimic vasculitis, aka inflammation of the blood vessels. That's why rheumatologists should maintain a high degree of suspicion when diagnosing California patients with the condition. This was the advice given by the presenter for the 12th Annual Rheumatology Nurses Society Conference.

If doctors misdiagnose a patient as having vasculitis and prescribe a high dose of glucocorticoids or other steroids, they may wind up harming the patient. One example of a vasculitis mimic is endocarditis, an infection of the heart's inner lining. One patient with endocarditis was misdiagnosed and subsequently suffered a stroke, becoming permanently disabled.

When patients reveal vasculitis-like syndromes for no apparent reason, doctors will need to consider the possibility of drug use, especially cocaine and amphetamine use. Another vasculitis mimic is a cholesterol embolus, that is, a clot caused by the lodging of cholesterol in a blood vessel. If one suspects cholesterol emboli, then an ophthalmologist must look at the patient's retina.

There's even a rare condition that can mimic vasculitis syndromes, particularly the central nervous system pseudovasculitis known as reversible cerebral vasoconstriction syndrome. It can be mistaken for a form of vasculitis called isolated angiitis of the central nervous system.

Someone who has been injured as a result of a misdiagnosis or delayed diagnosis may have good grounds for a medical malpractice claim. If successful, their claim could cover losses like past and future medical expenses, lost wages and any diminished ability to earn a living. A plaintiff may want a lawyer to help them obtain proof of malpractice and negotiate a fair settlement. Legal counsel may even speak on their behalf in court if negotiations fail.

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