Vasculitis is inflammation of the blood vessels. It changes the walls of blood vessels in different ways. It can cause the walls to thicken, weaken, narrow, or scar. The problem with these changes is that they restrict blood flow, leading to organ and tissue damage.
There are different types of vasculitis, and while some can impact just one organ, such as the skin, other forms can involve several organs. Vasculitis can be short term, or it can be chronic.
Symptoms of Vasculitis
Signs and symptoms of vasculitis can vary from person to person. They normally depend on the type of vasculitis, the organs involved, and the severity. For some, they become extremely ill, while others have very limited signs and symptoms. Also, the timing of the disorder can vary greatly. Some people will develop signs over months, while others start showing symptoms very quickly, even over a few days.
Since vasculitis can affect specific organs, a variety of symptoms are often reported. These can include:
- Fever
- Loss of appetite
- Weight loss
- Fatigue
- General aches and pains
- Skin
- Joints
- Lungs
- Gastrointestinal tract
- Sinuses, nose, throat, and ears
- Eyes
- Brain
- Nerves
Causes of Vasculitis
Research indicates that allergic reactions in the blood vessel walls can cause vasculitis. Substances that trigger allergic reactions are called antigens, and these antigens cause the body to make proteins, which attach to the antigen for the purpose of getting rid of it. Antigens and the proteins, known as antibodies, then attach and become immune complexes. Sometimes these immune complexes stay in the body too long—they circulate in the blood and deposit in tissues. And when they gather in blood vessel walls, they can cause inflammation, called vasculitis.
While the immune system is normally a protective organ of the body, in this case, it becomes “hyperactive” because of some unknown stimulus, leading to the inflammation. And this can lead to problems because when there is less blood flow, the more likely it is to have less oxygen and nutrients to organs and body tissue. This means the blood vessel is more susceptible to blood clots. If the blood clot weakens, it could mean an aneurysm may form.
Although rare, infections right in the blood vessel walls can also cause vasculitis. Whether it is bacteria, viruses, or fungi that are infecting the blood vessel, scientists say white blood cells move in to destroy the infectious agent and damage the vessel in the process.
Types of Vasculitis
There are two main types of vasculitis including primary vasculitis and secondary vasculitis. Primary is when vasculitis occurs with no known cause, and secondary is when it occurred because of another disease. These diseases can include hepatitis C, an immune system disorder, an allergic reaction, and some cancers.
There are approximately 20 different disorders that are classified as vasculitis. “Angiitis” and “Arteritis” are both synonyms for vasculitis, literally meaning “inflammation within blood vessels” or “inflammation in arteries.”
Some specific types of vasculitis are:
- Behcet’s disease: Characterized by the combination of mouth ulcers, genital ulcers, and eye inflammation. However, other organ systems may also be affected.
- Buerger’s disease: Decreased blood flow to the hands and feet, mainly affects smokers.
- Churg-Strauss syndrome: Associated with asthma, nasal polyps, sinusitis, and elevated eosinophil counts. It has a tendency to involve lungs, peripheral nerves, skin, kidneys, and heart.
- Cryoglobulinemia: Involves recurrent red dots on the lower extremities and may be associated with hepatitis C virus infections or paraproteinemias.
- Giant cell arteritis: The most common type of vasculitis in adults in North America. It is a large vessel vasculitis that affects people over the age of 50. It can be characterized by fever, headache, and jaw/scalp pain.
- Henoch-Schönlein purpura: This is often followed after an upper respiratory tract infection and is often, but not necessarily, self-limited.
- Takayasu’s arteritis: A large vessel vasculitis that affects the aorta, its major branches to the extremities, and internal organs. Usually occurs in younger women under the age of 50 years.
While these are just some of the different types of diseases that belong to the vasculitis category, they are all similar in some ways and differ in others. For example, they often differ because of which organs are affected, and which medications are used to treat them.
Vasculitis in Lupus
Vasculitis is a potential complication associated with lupus as the body’s immune system attacks the blood vessels. Blood vessels include arteries, veins, and capillaries carrying blood through the body and back to the heart.
Many people who have lupus will notice a sudden change in their symptoms if they develop vasculitis. One of the more common signs is a fever.
According to the journal Autoimmune Diseases, studies show that vascular disease is common in patients who suffer from lupus. Vasculitis may be recognized in as many as 56 percent of lupus patients throughout their lives. Lupus is a chronic inflammatory disease that happens when the immune system attacks the body’s own tissues and organs.
Research outlined in the U.S National Library of Medicine indicates that the earlier vasculitis is treated, the better the prognosis for those who have lupus vasculitis.
Diagnosis of Vasculitis
Most cases of vasculitis are diagnosed based on signs and symptoms, medical history, a physical exam, and test results. Lab tests including blood and urine can show any abnormal levels of certain blood cells and antibodies in the blood. Biopsy’s are also used to diagnose vasculitis, which is done by taking a small sample of an affected blood vessel or organ to study, looking for signs of inflammation or tissue damage. As all cases are different and symptoms differ, there are many ways a health practitioner may make a diagnosis. This can include not only blood and urine tests, but also electrocardiograms, chest x-ray, lung function tests, and abdominal ultrasounds.
Treatment and Prevention of Vasculitis
There really is no such thing as prevention of vasculitis, but with proper guidance, you can control the symptoms and get treatment.
The treatment of vasculitis and lupus depends on the individual’s general health and on the severity of the disease. There are some instances where vasculitis doesn’t require treatment at all.
In most cases, treatment will concentrate on controlling the inflammation. This is done with medications. When it comes to the vasculitis, a doctor might put a patient through treatment phases—stopping the inflammation and trying to prevent relapses. The kind of medications taken will depend on the type of vasculitis (the organs involved).
Some people see success with treatment right away, but then experience symptoms again. Others may notice that their vasculitis never goes away and they will require ongoing therapy.
People who suffer from severe vasculitis are often treated with corticosteroids and cytotoxic medicines. These medications can have side effects and should inflammatory-related by a physician. Certain types of vasculitis may even require surgery to remove aneurysms that have formed.
One of the most difficult aspects of living with vasculitis is coping with the side effects of medications. Research continues in an effort to develop therapies that are easier for patients. If you are a sufferer, there are steps you can take to lessen the pain and aggravation associated with vasculitis and lupus. Learn everything you can about vasculitis and treatment options, see your doctor for regular check-ups, exercise each day, maintain a healthy diet, and develop a strong support system. You can ask your doctor about connecting with a support group in your community.
Self-management of the illness involves understanding the treatment prescribed by doctors. It is vitally important to make lifestyle changes and to address the physical and emotional effect of having an autoimmune disease. There are many support groups that can help guide those wanting to learn more about the disease and will help to keep lifestyle changes on track. Self-management can help to encompass the choices made each day to live well and stay healthy. If you suspect you may have a type of vasculitis, be sure to see a doctor for treatment options.