Introduction to Vasculitis: Causes, Diagnosis, and Treatment

Vasculitis refers to a group of disorders that cause inflammation in your blood vessels. It’s also called angiitis or arteritis. It can cause your blood vessels to become weak, dilated, enlarged, or constricted. Damage to organs and tissues may occur if blood flow is restricted.

Vasculitis has several subtypes, most of which are infrequent. One or more organs may be impacted by vasculitis. Long-term or transient conditions are also possible. Although vasculitis may affect anyone, some forms are more prevalent in particular age groups. The majority of subtypes need medicine to reduce inflammation and minimize flare-ups.

CAUSES

It is unclear what causes vasculitis exactly. Several subtypes are influenced by genetics. Others happen when the immune system unintentionally attacks blood vessel cells. Possible triggers for this immune system reaction include:

• Infections, such as hepatitis B and hepatitis C
• Blood cancers
• Immune system diseases, such as rheumatoid arthritis, lupus, and scleroderma
• Reactions to certain drugs

COMPLICATIONS

• Aneurysm
• Blood flow to that area of your body may be partially or completely obstructed due to constriction of blood vessels
• Vision loss or blindness

SYMPTOMS

The majority of vasculitis types often manifest the following common signs and symptoms:

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

In accordance with the body parts affected, other signs and symptoms include:

• Digestive system – patients might have discomfort after eating if the stomach or intestines are affected. Blood in the stool is a potential symptom of ulcers and perforations
• Ears - vertigo, ringing in the ears, and sudden hearing loss
• Eyes - appear red and itchy or painful due to vasculitis. One or both eyes may become temporarily or permanently blind as a result of giant cell arteritis, which can also cause double vision
• Lungs – shortness of breath or coughing up blood
• Skin – Internal bleeding appears as red spots on the skin. Can also cause lumps or open sores

DIAGNOSIS

Tests and procedures include –

• Blood tests – The doctor can evaluate if you have enough red blood cells by conducting a complete blood count.  Anti-neutrophil cytoplasmic antibody (ANCA) test can help diagnose vasculitis
• Imaging tests – tests such as X-rays, ultrasound, computerized tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) can help evaluate blood vessels and organs affected
• Angiography – flexible catheter is inserted into an artery or vein. A special dye is injected into the catheter which fills the artery or vein and X-rays are taken
• Biopsy - a surgical procedure in which your doctor removes a small sample of tissue from the affected area of your body and examines the tissue for signs of vasculitis

TREATMENT

• Corticosteroids – known as steroids to fight inflammation. After administration close monitoring is done for possible side effects
• Methotrexate – can aid in lowering immunological function while having less severe adverse effects than steroids
• Tocilizumab - blocks an inflammatory protein in the body
• Avacopan - in the case of Anti-neutrophil cytoplasmic autoantibody (ANCA) associated vasculitis
• Surgery – in case of a condition called Aneurysm

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