Vasculitis

Vasculitis, also known as angiitis or arteritis, is an autoimmune disease that attacks your blood vessels. Imagine your blood vessels as water pipes. In vasculitis, these pipes become inflamed and narrowed, making it harder for blood to flow through them. In severe cases, some vessels might even close completely.

Reduced Blood Flow, Damaged Organs:

When blood flow to your organs and tissues is restricted, they can become damaged. This is why vasculitis can affect various parts of your body and cause a wide range of symptoms.

Signs and symptoms:

The symptoms vary depending on the affected area. Here are some common ones:

• Fever
• Weight loss
• Fatigue
• Headaches
• General aches and pains

Symptoms specific to certain areas include:

• Eyes: Redness, itchiness, burning, blurred vision, or even blindness.
• Skin: Rashes, lumps, or open sores.
• Nerves: Numbness, tingling, pain, or weakness.
• Brain: Stroke-like symptoms.
• Heart: Palpitations or heart attack.
• Kidneys: Kidney failure.
• Digestive System: Stomach or intestinal pain, blood in stool.
• Ears: Ringing, dizziness, hearing loss, inner ear infections.
• Hands and Feet: Numbness, weakness, swollen palms or soles.
• Lungs: Shortness of breath or coughing up blood.
• Genitals: Ulcers or open sores.
• Nose: Runny nose, sinus infections, blisters.
• Mouth: Swollen or dry lips and tongue.

Different Types of Vasculitis:

Doctors classify it based on the size of the affected blood vessels. Here are some common types:

1. Systemic Vasculitis: This type involves inflammation of blood vessel walls throughout the body.
2. Exercise-Induced Vasculitis: Occurs predominantly in women over 50 and affects small vessels in the lower legs, particularly after intense exercise in hot weather, resulting in transient leg rashes.
3. Urticarial Vasculitis: Affects small blood vessels in the skin, leading to patches, hives, itching, and potential damage to other organs.
4. Leukocytoclastic Vasculitis: Caused by immune cell waste inflammation in small blood vessel walls, resulting in raised spots, primarily on the legs. It can spread to other organs if severe.
5. ANCA Vasculitis: Targets specific white blood cells, triggering inflammation in small blood vessels across various body parts, leading to diverse symptoms depending on the affected area.
6. IgA Vasculitis: Common in children, it causes inflammation and bleeding in small blood vessels of the skin, joints, intestines, and kidneys, often presenting as a raised rash on the legs or buttocks.
7. Cutaneous Vasculitis: Characterized by inflammation and damage to skin blood vessels, typically appearing as raised patches.
8. Central Nervous System (CNS) Vasculitis: Involves inflammation of blood vessel walls in the brain and spine, often related to immune system dysfunction but treatable.
9. Rheumatoid Vasculitis: A complication of rheumatoid arthritis where inflammation damages blood vessels, commonly affecting small to medium vessels in the skin, nerves, fingers, and toes.

Other types include giant cell arteritis, polyarteritis nodosa, Takayasu arteritis, Behçet’s disease, and Kawasaki disease.

What Causes Vasculitis?

The exact cause of is unknown in many cases. However, some possible triggers include:

• Autoimmune diseases (e.g., rheumatoid arthritis, lupus)
• Infections (e.g., hepatitis B or C)
• Allergic reactions to medications
• Certain blood cancers

Risk Factors:

Certain factors can increase your chances of developing angiitis, including:

• Age (some types are more common in older adults, while others affect children)
• Family history of the condition
• Cocaine use
• Smoking
• Certain medications

Diagnosis:

When you visit your doctor with concerns about this condition, they will first inquire about your medical history and conduct a physical examination. Since there isn’t a specific test solely for angiitis your doctor may perform various tests to detect inflammation and identify the underlying cause of your symptoms. These diagnostic procedures might include:

1. Blood Tests: Certain blood cell counts or antibodies can indicate the presence of angiitis.
2. Urine Tests: These tests assess kidney function and look for signs of kidney damage.
3. Imaging Tests: X-rays, MRI scans, CT scans, PET scans, ultrasounds, and angiograms can reveal inflammation in blood vessels and organs.
4. Heart Tests: An echocardiogram evaluates heart function.
5. Biopsy: A tissue sample is taken for examination to detect signs of inflammation or damage.

Treatment:

The choice of treatment for this condition depends on its underlying cause and the organs affected. The primary goal is to control inflammation and prevent damage to organs and blood vessels. Treatment options include:

1. Medications:
   • Steroids like prednisone are commonly prescribed to combat inflammation. Regular monitoring for side effects like high blood pressure, high blood sugar, and bone issues is essential, especially with long-term use.
   • Other medications such as azathioprine, cyclophosphamide, methotrexate, mycophenolate, rituximab, or tocilizumab may be prescribed in conjunction with steroids, depending on the severity of the condition and individual medical history.
2. Surgery: In some cases, surgery may be necessary to address complications arising from angiitis, such as repairing blood vessel bulges (aneurysms) or restoring blood flow in blocked arteries.

Complications:

The severity of complications depends on the type and severity of vasculitis. Some potential complications include:

• Organ damage
• Blood clots
• Aneurysms
• Vision loss
• Infection

How common is vasculitis?

Most types of angiitis are rare, affecting fewer than 50 out of 1 million people each year.

Living with Vasculitis:

While this condition is a lifelong condition, there’s no cure. However, with proper treatment, many people can live active lives. Here are some tips for managing vasculitis:

• Learn about the disease and understand the importance of sticking to your treatment plan.
• Exercise regularly to improve your mood, reduce stress, and maintain overall health.
• Eat a healthy diet rich in fruits, vegetables, whole grains, and lean protein.
• Keep vaccinations up-to-date to prevent infections.
• Seek support from family, friends, or support groups.

sources:

• Mayo Clinic
• National Heart, Lung, and Blood Institute (NHLBI)
• Arthritis Foundation
• National Library of Medicine
• American College of Rheumatology
• Versus Arthritis
• Johns Hopkins Vasculitis Center
• American College of Rheumatology
• National Jewish Health (ANCA Vasculitis)
• Vasculitis Foundation (Specific Types)
• American College of Rheumatology (Tocilizumab)
• UpToDate for Patients (Rheumatoid Arthritis Treatment)
• University of Michigan Health
• Cleveland Clinic (Cutaneous Vasculitis, Central Nervous System Vasculitis)
• American Osteopathic College of Dermatology (Leukocytoclastic Vasculitis)
• Canadian Medical Association Journal (Exercise-induced Vasculitis)
• Lupus Foundation of America (Vasculitis and Lupus)
• Frontiers in Medicine (Cutaneous Vasculitis Diagnosis)