Chapter 8 - Diseases of small and medium-sized blood vessels

Abstract

Nonatherosclerotic diseases of small and medium-sized blood vessels include a wide variety of conditions, including the inflammatory vasculitides such as leukocytoclastic vasculitis, Kawasaki disease, polyarteritis nodosa, giant cell arteritis, and infection. There are also genetic conditions that affect small and medium-sized blood vessels such as pseudoxanthoma elasticum, neurofibromatosis, and coronary artery dissection associated with Loeys–Dietz syndrome. Endocrine disorders such as diabetes and infectious agents such as Rickettsia also cause vascular disease. Alterations in coagulation and blood pressure cause well-known pathologic changes in the vasculature. Some disorders cause deposition of material in the vessels such as amyloidosis and oxalosis, while other disorders, such as Moyamoya disease, are intimal proliferative disorders, causing occlusive intimal hyperplasia. Blood vessels are also damaged by external phenomenon including radiation therapy and trauma. Understanding the similarities and differences in the morphologies of these diverse vascular disorders is important for both proper diagnosis and to further our understanding of the basic mechanisms of these diseases.