Vasculitis is the general term used to reference conditions involving inflammation of the blood vessels. The condition can come in many forms, and each form is often rare. It can affect one or more organs and be chronic or short-term. Vasculitis can remain in a state of remission or flare up at any time. Vasculitis is also known as angiitis.
Definition & Facts
Vasculitis is the term used when inflammation is found in blood vessels. Blood vessel walls can become scarred, narrowed, and weakened which causes restricted blood flow, which in turn causes damaged organs and tissues. Around 3 million individuals in the United States are reported to have this condition, although it is difficult to determine since vasculitis is often used as a general term to describe a number of diseases.
Symptoms & Complaints
- Unexplained weight loss
- Aches and pains all over the body
- Numbness or weakness caused by nerve problems
- Loss of pulse in an extremity
Varied forms of vasculitis create different symptoms:
- Cryoglobulinemia is a condition that is related to hepatitis C and is the result of abnormal proteins in the blood. Symptoms include numbness, tingling, rash, weakness, and joint pain.
- Giant-cell arteritis typically occurs in people over the age of 50 and is linked to polymyalgia rheumatica. Giant-cell arteritis involves inflammation in the arteries partially at the temples and can cause vision problems, headaches, jaw pain, and scalp tenderness.
- Behcet’s syndrome typically appears in an adult’s 20s or 30s and involves inflammation in veins and arteries. The condition is signified by lesions on the skin, genital ulcers, mouth ulcers, and eye inflammation.
- Buerger’s disease involves clots and inflammation in the blood vessels located in the feet and hands. Also known as thromboangiitis obliterans, this condition causes leg pain, foot pain, arm pain, hand pain, and ulcers on the toes and fingers can also appear. Buerger’s disease is linked to cigarette smoking and use of tobacco products in general.
- Kawasaki disease, also called mucocutaneous lymph node syndrome, causes rash, fever, and eye inflammation. It typically affects children under the age of 5.
- Granulomatosis with polyangiitis. Also known as Wegener's granulomatosis, this condition involves the inflammation of the kidneys, lungs, nose, throat, and sinuses. Once affected, lumps occur in the tissue. Symptoms include nosebleeds, congestion, sinus infections, and kidney issues.
- Takayasu’s arteritis. This condition often occurs in young adult women and carries the symptoms of numbness in the limbs, high blood pressure, visual issues, and headaches. It is caused by vasculitis in the large arteries of the body such as the aorta.
Severe complications of vasculitis include the following:
- Organ damage: Severe forms of vascultis can become severe and cause organ damage.
- Aneurysms and blood clots: If vasculitis obstructs blood flow, a blood clot can develop. An aneurysm can also occur if vasculitis causes a blood vessel to expand and weaken.
- Infection: Sepsis and pneumonia are possible complications of vasculitis
- Blindness: Untreated giant-cell arteritis can cause blindness.
While the exact origin of vasculitis is unknown to date, some forms of vasculitis are linked to genetic factors. Certain types of vasculitis such as Henoch-Schönlein purpura, Kawasaki disease, and Takayasu's arteritis affect Asian children and young adults more than any other race and gender.
Drug reactions, infections, autoimmune diseases, and blood cancers can be the cause of vasculitis that attacks the blood vessels. The risk of developing certain other types of vasculitis is also increased if an individual has had certain conditions such as hepatitis B or hepatitis C.
Diagnosis & Tests
A physical examination and an in-depth study of an individual’s medical health is the first step in diagnosing vasculitis. The following procedures and diagnostic tests are also used to pinpoint vasculitis:
- Blood tests may be used. A complete blood count determines if an individual has the proper amount of red blood cells. Other blood tests look for antibodies in the blood that indicate vasculitis as well as high levels of C-reative protein.
- Urine testing may also be used. Problems can be found if urine contains a high level of protein or red blood cells.
- Imaging test such as the PET scan, MRI, CT scan, X-rays, and ultrasound help establish what organs and blood vessels are affected by vasculitis.
- A biopsy may be taken which involves a doctor extracting a small piece of affected tissue in order to probe for signs of vasculitis.
- Angiography may also be utilized. It involves a dye being injected into a vein or large artery through a catheter. The dye makes blood vessels more prominent for clearer X-rays.
Treatment & Therapy
Treatment focuses on healing the underlying conditions that caused vasculitis as well as reducing inflammation. The two phases of vasculitis treatment involve using medications to stop inflammation and inhibit relapses. Medications used to treat vasculitis include:
- Corticosteroids such as methylprednisolone and prednisone reduce inflammation in the blood vessels, but are not often used for long-term care due to potential side effects such as bone thinning, weight gain, and diabetes.
- Immunosuppresants are prescribed when the body does not respond to corticosteroids. These types of medicines reduce inflammation by blocking immune system cell function. Side effects of this medication include infertility and increased risk of cancer and infection.
- Monoclonal antibodies such as rituximab is used as a maintenance therapy in some forms of vasculitis. This medicine should not be used if an individual has had hepatitis B to prevent reactivating it.
Prevention & Prophylaxis
Surgery may also be used in rare cases. Early diagnosis and treatment are the best forms of prevention in this case; doing so can send vasculitis into remission without affecting major organs.