Vasculitis (disease) - symptoms and treatment

Vasculitis (disease) - symptoms and treatment

What is Vasculitis

Vasculitis - a group of AUTOIMMUNE DISORDERS in which the epithelium (lining) of the BLOOD vessels becomes inflamed. The INFLAMMATION causes localized PAIN and swelling. There are numerous forms of vasculitis. They share common characteristics and symptoms though each of which has unique traits. Vasculitis may be acute (come on suddenly, run its course, and be over) or chronic (symptoms persist or come and go). Though vasculitis can affect any kind of blood vessel in the body, it most often involves arteries.

Symptoms of Vasculitis and Diagnostic Path

Each type of vasculitis has unique symptoms. All types of vasculitis have in common these general symptoms:

  • weight loss and loss of APPETITE
  • fatigue
  • MUSCLE aches and PAIN
  • JOINT pain and swelling

The doctor may conduct BLOOD tests to measure ANTIBODY types and levels, blood cell counts, and sedimentation rate and C-REACTIVE PROTEIN level (the latter two are indicators of inflammation in the body). Diagnostic imaging procedures such as Doppler ULTRASOUND, MAGNETIC RESONANCE IMAGING (MRI) COMPUTED TOMOGRAPHY (CT) SCAN, and angiogram can demonstrate any damage to or obstruction (blockage) of the arteries and veins. Sometimes a biopsy of the involved blood vessel is necessary to confirm the diagnosis.

Type of VasculitisUnique SymptomsTreatment and Outlook
giant cell arteritis (temporal arteritis) primarily occurs in adults over age 50
affects arteries in the upper body, notably the neck and head (carotid network)
severe HEADACHE, jaw PAIN, and scalp tenderness
blind spots (scotoma), blurred vision, and other vision disturbances
high-DOSE corticosteroid medications for two to four weeks
long-term corticosteroid therapy
delayed treatment establishes high risk for blindness resulting from optic NEUROPATHY
tends to be chronic
Henoch-Schönlein purpura primarily occurs in children under age 6
purplish RASH on the legs and feet
acute illness that lasts about 2 weeks
affects blood vessels of the skin, joints, gastrointestinal tract, and KIDNEYS
complete recovery without treatment (self limiting course of disease)
possible complications, though uncommon, include RENAL FAILURE and GASTROINTESTINAL BLEEDING
hypersensitivity vasculitis (leukocytoclastic vasculitis) affects small arteries in the skin, kidneys, gastrointestinal tract, lungs, and joints
palpable (raised) PURPURA, commonly on the legs
corticosteroid medications or immunosuppressive medications when involvement is systemic
symptoms can be recurrent
KAWASAKI’S DISEASE (mucocutaneous LYMPH NODE syndrome) occurs primarily in children under age 5
acute onset with high FEVER lasting five days to two weeks
fever does not drop with aspirin or acetaminophen
inflamed and reddened eyes, reddened and chapped lips, peeling skin, and joint pain
high-dose, intravenous GAMMAGLOBULIN
most children fully recover without complications
risk for coronary ARTERY INFLAMMATION and aortic ANEURYSM
requires lifelong monitoring for CARDIOVASCULAR DISEASE (CVD)
microscopic polyangiitis more common in adults over age 50
affects arteries in the kidneys, skin, lungs, and that serve PERIPHERAL NERVES
purpura and other skin rashes
neuropathy and loss of NERVE function to feet and hands
alveolar hemorrhage (bleeding into the tiny air sacs in the lungs)
corticosteroid medications in combination with immunosuppressive medications
trimethoprim/sulfamethoxazole (antibiotic therapy)
polyarteritis nodosa affects arteries in the LIVER, gastrointestinal tract, kidneys
purpura and skin ulceration
pain in the joints and large muscles
abdominal pain
aggressive, high-dose corticosteroid medications at diagnosis
immunosuppressive medications for nonresponsive or severe symptoms
long-term corticosteroid therapy to control chronic disease
antihypertensive therapy
untreated or severe disease has high risk for death
complications include renal failure, LIVER FAILURE, and HEART FAILURE
polymyalgia rheumatica primarily occurs in adults over age 60
severe pain and inflammation in the large joints (knees, hips, shoulders)
corticosteroid medications
chronic symptoms requiring long-term treatment may indicate underlying giant cell arteritis
Takayasu arteritis affects the AORTA and other large arteries
most common in women between ages 20 and 35
pain and weakness in the back and arm on the affected side
lower BLOOD PRESSURE in the arm on the affected side
headache, dizziness, and vision disturbances
corticosteroid medications
immunosuppressive medications for severe symptoms
ANTICOAGULATION THERAPY such as aspirin or warfarin
spontaneous resolution in about 95 percent of people
possible complications include STROKE, HEART ATTACK, severe hypertension, aortic aneurysm, and heart failure
thromboangiitis obliterans (Buerger’s disease) most common in men aged 20 to 40 who smoke
affects blood vessels in arms, hands, legs, and feet
leg cramps with walking (INTERMITTENT CLAUDICATION)
altered sensation or loss of sensation in feet (paresthesia)
ulcerations on fingers and toes with rapid progression to GANGRENE (tissue death)
rest until inflammation subsides
regular walking to improve circulation and muscular support for blood vessels
aggressive treatment for ulcers that develop
AMPUTATION of gangrenous digits or extremities
chronic condition that requires diligent lifestyle management to minimize symptoms
Wegener’s granulomatosis more common in men over age 40
affects blood vessels in the NOSE, SINUSES, THROAT, lungs, and kidneys, often causing ulcerations
forms multiple granulomas
immunosuppressive medications
corticosteroid medications with mild symptoms and early diagnosis
trimethoprim/sulfamethoxazole (antibiotic therapy) treatment eliminates symptoms in 50 percent of people
severe or untreated symptoms can be fatal
outlook best with early diagnosis and treatment

Vasculitis Treatment Options and Outlook

Some types of vasculitis are self-limiting and do not require treatment. For most, treatment may include NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS), CORTICOSTEROID MEDICATIONS, and IMMUNOSUPPRESSIVE MEDICATIONS that have cytotoxic (cellkilling) effects (such as azathioprine and cyclophosphamide). The person may take one kind of medication or a combination of medications, depending on the symptoms and their severity. Nutritional EATING HABITS and daily physical exercise such as walking also aid HEALING and improved function.

Risk Factors and Preventive Measures

Doctors do not know what causes most vasculitis, though people who have autoimmune disorders are more likely to develop some type of vasculitis. Because some forms of vasculitis have potentially severe or life-threatening complications, early diagnosis and treatment are essential for optimal recovery or disease management. Many of the medications doctors prescribe to treat vasculitis have significant side effects such as OSTEOPOROSIS so it is important to be vigilant about such conditions.


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