White Matter Specifications in Different Secondary Vasculitic Lesions

Abstract

Background: Vasculitis is characterized by vessel wall inflammation leading to a beaded appearance of the arteries with variable degrees of stenosis and ectasia. Aim: The aim of this work was to clarify a systemic approach to differentiate some secondary vasculitic diseases through their white matter distribution and morphology. Methods: This cross-sectional prospective study was carried out on 30 systemic vasculitis patients aged 18 years or more, of both sexes. All patients underwent detailed history taking, complete general and neurological examination, laboratory workup, rheumatoid factor when indicated, serological tests for vasculitis [antinuclear, anti–double stranded DNA, anti-Ro, anti–cyclic citrullinated peptide, anticardiolipin, anti-neutrophil cytoplasmic, and lupus anticoagulant antibodies], brain imaging [Magnetic resonance imaging (MRI) of the brain, with magnetic resonance venography and magnetic resonance angiography]. Results: Total WMH volume showed a moderate negative correlation with disease duration (r = -0.398, P = 0.029), indicating that longer disease duration was associated with slightly lower total WMH burden. Similarly, deep WMH volume was negatively correlated with disease duration (r = -0.393, P = 0.032), and periventricular confluent WMH volume demonstrated the strongest negative correlation (r = -0.480, P = 0.007). Conclusions: MRI findings alone may not be specific enough to distinguish different secondary vasculitic lesions, and further clinical correlation and investigations are often required.