Vasculitis
Vasculitis is the inflammation of your blood vessels. It happens when the body's immune system attacks the blood vessel by mistake. Your blood vessels include arteries, veins and capillaries. Arteries are vessels that carry blood from the heart to the body's organs. Veins are the vessels that carry blood back to the heart. Capillaries are tiny blood vessels that connect the small arteries and veins. Vasculitis causes changes in the blood vessel walls, including thickening, weakening, narrowing or scarring. These changes can restrict blood flow, resulting in organ and tissue damage.
Vasculitis might affect just one organ, or several. The condition can be short term (acute) or long lasting (chronic). Vasculitis can affect anyone, though some types are more common among certain groups. Depending on the type you have, you may improve without treatment. Some types require medications to control the inflammation and prevent flare-ups.
Types of Vasculitis
The different types of vasculitis are classified according to the size and location of the blood vessels that are affected. Some of the most common types include the following:
- Hypersensitivity Vasculitis: This type is often used to describe different types of vasculitis related to drug reactions, skin disorders or allergic vasculitis.
- Isolated Aortitis: A general term which means inflammation of the aorta, the large blood vessel which transports blood from the heart to the body.
- Buerger’s Disease: This type mostly affects the small to medium-sized arteries and veins of the extremities, and leads to decrease or loss of blood supply (ischemia) distally, and in severe cases may cause ulcers and gangrene.
- Microscopic Polyangiitis: A type of vasculitis which affects small vessels, such as arterioles (small arteries), capillaries and venules (small veins).
- Rheumatoid Vasculitis (RV): A serious complication of long standing rheumatoid arthritis (RA) in which inflammation spreads to involve small to medium-sized and rarely, large blood vessels in the body.
- Henoch-Schönlein Purpura (HSP): The most common type of vasculitis in children. This types resolves in most patients without the need for aggressive treatment. It rarely occurs in adults. It typically presents with a skin rash, pain in the abdomen and arthritis.
Causes of Vasculitis
The exact cause of vasculitis isn't fully understood. However, other conditions, traits or habits may also play a role in raising your risk. These conditions are known as risk factors and include:
Non-Modifiable Risk Factors: These factors are irreversible and cannot be changed. The more of these risk factors you have, the greater your chance of developing vasculitis.
- Family History/Genetics
Modifiable Risk Factors: These factors can be modified, treated or controlled through medications or lifestyle changes.
- Long history of cigarette smoking and/or drug abuse.
- Reactions to certain medications.
Other conditions that contribute to the development of vasculitis:
- Infections, such as hepatitis B and hepatitis C.
- Aneurysms
- Certain blood disorders (i.e. anemia, hemophilia, blood clots, and blood cancer, leukemia, lymphoma, and myeloma).
- Autoimmune Disease: A condition in which your immune system mistakenly attacks your body (e.g. lupus, rheumatoid arthritis and scleroderma).
Symptoms of Vasculitis
The symptoms of vasculitis vary greatly. They're often related to decreased blood flow throughout the body. Some common symptoms include:
- Fever
- Headache
- Fatigue
- Unexplainable weight loss
- General aches and pains
- Night sweats
- Rashes
- Nerve problems, such as numbness or weakness.
Diagnosis of Vasculitis
To diagnose your condition, your doctor will ask you about your symptoms. You'll also have a physical exam. Otherwise, your doctor will recommend the following diagnostic tests and procedures:
- Blood tests
- Urinalysis
- Angiogram
- Tissue biopsy
- X-Rays
- Ultrasound
- Computed tomography (CT scan)
- Magnetic resonance imaging (MRI)
Treatment of Vasculitis
Treatment focuses on controlling the inflammation with medications and resolving any underlying disease that triggered your vasculitis. Treatment options include:
Lifestyle Changes
- Avoid smoking.
- Avoid certain medications (i.e. antiseizure, blood pressure, antibiotics, among others).
- Exercise under the directions of your doctor.
- Make and keep appointments to see your doctor for routine check-ups and follow-up tests.
Medications
- Inflammation medications will help reduce any swelling.
- Biologic therapies such as rituximab (Rituxan) or tocilizumab (Actemra) may be recommended, depending on the type of vasculitis you have.