Vasculitis is a group of rare disorders characterized by inflammation of blood vessels. This inflammation can cause the walls of affected blood vessels (arteries, veins, and capillaries) to thicken, weaken, narrow, or scar. As a result, blood flow can become restricted, potentially leading to organ and tissue damage.
Types of Vasculitis
Vasculitis can be classified based on the size of the affected blood vessels:
- Large Vessel Vasculitis:
- Giant Cell Arteritis (Temporal Arteritis): Often affects arteries in the head and neck, especially in older adults.
- Takayasu's Arteritis: Affects large arteries, like the aorta, mostly in young women.
- Medium Vessel Vasculitis:
- Polyarteritis Nodosa: Affects medium-sized arteries, potentially impacting multiple organs.
- Kawasaki Disease: Common in children, causing fever and inflammation of coronary arteries.
- Small Vessel Vasculitis:
- Granulomatosis with Polyangiitis (GPA, formerly Wegener's): Affects small blood vessels in the nose, sinuses, lungs, and kidneys.
- Microscopic Polyangiitis: Primarily affects kidneys and lungs.
- Henoch-Schönlein Purpura (HSP): Causes a purplish rash, joint pain, and kidney issues, often in children.
- Churg-Strauss Syndrome (Eosinophilic Granulomatosis with Polyangiitis): Often associated with asthma and allergies.
Causes
The exact cause of vasculitis is often unknown, but it may be triggered by:
- Autoimmune reactions (the immune system attacks blood vessels).
- Infections, like hepatitis B or C.
- Reactions to medications.
- Other conditions, such as rheumatoid arthritis, lupus, or cancer.
Symptoms
Symptoms vary depending on the type and location of vasculitis but may include:
- General Symptoms:
- Fatigue
- Fever
- Weight loss
- Muscle and joint pain
- Specific Symptoms:
- Skin: Rash, ulcers, or purpura (purple spots).
- Joints: Pain or arthritis.
- Lungs: Shortness of breath, coughing (possibly with blood).
- Kidneys: Blood in urine or kidney failure.
- Nervous System: Numbness, weakness, or strokes.
- Digestive Tract: Abdominal pain, diarrhea, or bleeding.
- Eyes: Vision changes or redness.
Diagnosis
- Physical Exam:
- Checking for rashes, swelling, or other signs of inflammation.
- Blood Tests:
- Elevated inflammatory markers (C-reactive protein, ESR).
- Antibodies (e.g., ANCA for GPA and microscopic polyangiitis).
- Urine Tests:
- To detect blood or protein, indicating kidney involvement.
- Imaging Tests:
- X-rays, CT scans, MRI, or PET scans to assess blood vessel inflammation.
- Biopsy:
- Taking a tissue sample from an affected blood vessel or organ.
- Angiography:
- Imaging to view blood vessels and check for narrowing or blockages.
Treatment
Treatment focuses on reducing inflammation and managing underlying causes:
- Medications:
- Corticosteroids: To suppress inflammation (e.g., prednisone).
- Immunosuppressants: For severe cases (e.g., cyclophosphamide, methotrexate, azathioprine).
- Biologics: Such as rituximab for specific types of vasculitis.
- Antiviral Therapy: If an infection triggers vasculitis.
- Plasma Exchange:
- Used in severe cases to remove harmful antibodies from the blood.
- Symptom Management:
- Pain relievers or blood pressure medications as needed.
- Lifestyle:
- Rest, healthy diet, and regular checkups to monitor organ function.
Complications
If untreated, vasculitis can lead to:
- Organ damage or failure (e.g., kidneys, lungs, heart).
- Aneurysms (weakened blood vessel walls that bulge).
- Blood clots or strokes.
- Permanent vision loss (in giant cell arteritis).
Prognosis
- The outlook depends on the type, severity, and treatment response.
- Early diagnosis and proper treatment improve the chances of remission and reduce the risk of complications.
If you suspect vasculitis, consult a healthcare provider immediately, as early intervention can prevent serious damage.
