Vasculitis

Vasculitis

Vasculitis is an inflammation of the blood vessels. Due to inflammation, it can cause the walls of your blood vessels to thicken and reduce the width of the passage through the vessels. If blood flow is restricted, it can result in additional complications such as organ and tissue damage.

There are many different types of vasculitis. However, most of them are rare. The condition can affect just one organ or several, and the condition can be short-term or long-lasting.

Vasculitis can affect anyone, yet some types are more common among certain age groups. Depending on the type you have, your condition may improve without the need for treatment. Medications are used to control inflammation and prevent flare-ups.

Signs and Symptoms of Vasculitis

There are some general signs and symptoms of vasculitis that include:

• Fever
• Headache
• Fatigue
• Weight loss
• General aches and pains
• Kidney problems

Additional signs and symptoms specific to parts of the body can also include:

• Digestive system: vasculitis can affect our stomach or intestines as you may experience pain after eating. Ulcers and perforations are a possibility and may result in blood in your stool.
• Ears: Dizziness and ringing in the ears. Abrupt hearing loss may also happen.
• Eyes: Vasculitis can affect your eyes and make them look red, itch or burn. Giant cell arteritis may give you double vision and temporary or permanent blindness in one or both eyes. This is generally the first sign of the disease.
• Hands and feet: Numbness in the hands or feet is sometimes experienced among patients. The palms of the hands and soles of the feet may also swell or harden.
• Lungs: Shortness of breath or coughing up blood is a sign that vasculitis has affected your lungs.
• Bleeding under the skin can show up as red sports for vasculitis patients. Vasculitis can cause lumps or open sores on your skin as well.

Types of Vasculitis

• Behcet's disease
• Buerger disease
• Churg-Strauss syndrome
• Cryoglobulinemia
• Giant cell arteritis
• Granulomatosis with polyangiitis
• Henoch-Schonlein purpura
• Kawasaki disease
• Takayasu's arteritis

Causes of Vasculitis

The direct cause of vasculitis isn't fully developed. Some types of the disease are related to a person's genetics, while others result from the immune system attacking blood vessel cells by mistake.

• Infections: hepatitis B and hepatitis C
• Blood cancers: leukemia, lymphoma and myeloma
• Immune system disease: rheumatoid arthritis, lupus and scleroderma
• Reactions to a certain drug

Vasculitis Complications

Depending on the type and severity of your vasculitis, additional complications are possible to develop. Vasculitis can also develop due to the side effects of prescription medications you're taking to treat another condition.

They can include the following:

• Organ damage
• Blood clots and aneurysms
• Vision loss or blindness
• Infections

Diagnosing Vasculitis

At first, your doctor will most likely start by reviewing your medical history and performing a physical exam. Afterward, they may have you undergo additional diagnostic tests and procedures. These tests are to rule out other conditions that mimic vasculitis.

• Blood tests: check for high levels of C-reactive protein, which is a sign of inflammation. Additional tests can look for certain antibodies, such as anti-neutrophil cytoplasmic antibody (ANCA) tests, generally used to diagnose vasculitis.
• Imaging tests: noninvasive imaging techniques can be used to help determine which blood vessels and organs are being affected. Additionally, they can be used to determine if your body is responding well to treatment. Imaging tests can include X-rays, ultrasounds, computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).
• Angiography is used to X-ray your blood vessels, and a flexible catheter will be inserted into a large artery or vein. Your surgeon will inject a dye into the catheter that will show up on X-rays as it fills the artery or vein. The X-ray results will show the outlines of your blood vessels.
• Biopsy: a surgical procedure in which your doctor removes a small sample of tissue from the affected area in your body. Your doctor will use this sample to examine whether there are signs of vasculitis.

Treatment for Vasculitis

The goal of treatment is to focus on controlling the inflammation and managing any underlying conditions. Your doctor may recommend a medication or surgical procedure.

Medications

The most common type of drug prescribed to patients is a corticosteroid drug. This is used to control the inflammation associated with vasculitis.

However, the side effects of corticosteroids can be severe for some patients, especially if you take them for long periods of time. Possible side effects from the medication can include weight gain, diabetes and weakened bones. If your doctor prescribes you to a corticosteroid as a long-term therapy, you'll most likely receive the lowest dose possible.

Your doctor may pair another medication with your prescribed corticosteroid to control inflammation, and taper use the corticosteroid usage more quickly. Depending on the type of vasculitis you have, your doctor may recommend methotrexate (Trexall), azathioprine (Imuran, Azasan), mycophenolate (CellCept), cyclophosphamide, tocilizumab (Actemra) or rituximab (Rituxan).

Surgery

Sometimes, vasculitis can cause patients aneurysms, a bulge or ballooning in the wall of a blood vessel. If this happens, surgery may be needed to reduce the risk of it rupturing. Blocked arteries may also need surgical treatment to restore blood flow.

Our physicians use a multidisciplinary approach to treat the complex symptoms of individuals living with lupus and rheumatic diseases such as rheumatoid arthritis, Sjogren's syndrome and scleroderma. We strive to provide complete care, including management of related secondary conditions frequently associated with autoimmune diseases, such as heart disease and diabetes.