Vasculitis

Vasculitis is when your blood vessels are inflamed. There are many different blood vessels in the body, and vasculitis can affect any of them. This includes large (veins and arteries) and small (capillaries) vessels. With vasculitis,

  • Blood vessel walls can become thick.

  • Blood vessels can become narrow.

  • Blood vessels can become weak. Sometimes, it becomes so weak that the blood vessel bulges out like a balloon. This is called an aneurysm. Aneurysms are rare but can be life-threatening.

  • Scarring can occur.

  • Not enough blood can flow through the blood vessels.

All of these things can damage many parts of the body, including the muscles, kidneys, lungs and brain.

There are many types of vasculitis. Some types are short-term (acute), while others are long-term (chronic). Some types may go away without treatment, and others may need to be treated for a long time.

CAUSES

Vasculitis occurs when the body's immune system (which fights germs and disease) makes a mistake. It attacks its own blood vessels. This causes inflammation (the body's way of reacting to injury or infection).

  • Why this happens is usually not known. The condition is then called primary vasculitis.

  • Sometimes, something triggers the inflammation. This is called secondary vasculitis. Possible causes include:

  • Infections.

  • An immune system disease. Examples include lupus, rheumatoid arthritis and scleroderma.

  • An allergic reaction to a medicine.

  • Cancer that affects blood cells. This includes leukemia and lymphoma.

  • Males and females of all ages and races can develop vasculitis. Some risk factors make vasculitis more likely. These include:

  • Smoking.

  • Stress.

  • Physical injury.

SYMPTOMS

There are more than 20 types of vasculitis. Symptoms of each type vary, but some symptoms are common.

  • Many people with vasculitis:

  • Have a fever.

  • Do not feel like eating.

  • Lose weight.

  • Feel very tired.

  • Have aches and pains.

  • Feel weak.

  • Start to not have feeling (numbness) in an area.

  • Symptoms for some types of vasculitis also could be:

  • Sores in the mouth or eyes.

  • Skin problems. This could be sores, spots or rashes.

  • Trouble seeing.

  • Trouble breathing.

  • Blood in the urine.

  • Headaches.

  • Pain in the abdomen.

  • Stuffy or bloody nose.

DIAGNOSIS

Vasculitis symptoms are similar to symptoms of many other conditions. That can make it hard to tell if you have vasculitis. To be sure, your caregiver will ask about your symptoms and do a physical exam. Certain tests may be necessary, such as:

  • A complete blood count (CBC). This test shows how many red blood cells are in your blood. Not having enough red blood cells (anemic) can result from vasculitis.

  • Erythrocyte sedimentation (also called sed rate test). It measures inflammation in the body.

  • C reactive protein (CRP). This also shows if there is inflammation.

  • Anti-neutrophil cytoplasmic antibodies (ANCA). This can tell if the immune system is reacting to certain cells in the blood.

  • A urine test. This checks for blood or protein in the urine. That could be a sign of kidney damage from vasculitis.

  • Imaging tests. These tests create pictures from inside the body. Options include:

  • X-rays.

  • Computed tomography (CT) scan. This uses X-rays guided by a computer.

  • Ultrasound. It creates an image using sound waves.

  • Magnetic resonance imaging (MRI). It uses radio waves, magnets and a computer.

  • Angiography. A dye is put into your blood vessels. Then, an X-ray is taken of them.

  • A biopsy of a blood vessel. This means your caregiver will take out a small piece of a blood vessel. Then, it is checked under a microscope. This is an important test. It often is the best way to know for sure if you have vasculitis.

TREATMENT

  • Treatment will depend on the type of vasculitis and how severe it is. Often, you will need to see a specialist in immunologic diseases (rheumatologist).

  • Some types of vasculitis may go away without treatment.

  • Some types need only over-the-counter drugs.

  • Prescription medicines are used to treat many types of vasculitis. For example:

  • Corticosteroids. These are the drugs used most often. They are very powerful. Usually, a high dose is taken until symptoms improve. Then, the dose is gradually decreased. Using corticosteroids for a long time can cause problems. They can make muscles and bones weak. They can cause blood pressure to go up, and cause diabetes. Also, people often gain weight when they take corticosteroids.

  • Cytotoxic drugs. These kill cells that cause inflammation. Sometimes, they are used if corticosteroids do not help. Other times, both medications are taken.

  • Surgery. This may be needed to repair a blood vessel that has bulged out (aneurysm).

  • Treatment can sometimes cure your disease. Other times, it can put the disease in remission (no symptoms). Increased treatment and reevaluation might be necessary if your disease comes back or flares.

HOME CARE INSTRUCTIONS

  • Take any medications that your caregiver prescribes. Follow the directions carefully.

  • Watch for any problems that can be caused by a drug (side effects). Tell your caregiver right away if you notice any changes or problems.

  • Keep all appointments for checkups. This is important to help your caregiver watch for side effects. Checkups may include:

  • Periodic blood tests.

  • Bone density testing. This checks how strong or weak your bones are.

  • Blood pressure checks. If your blood pressure rises, you may need to take a drug to control it while you are taking corticosteroids.

  • Blood sugar checks. This is to be sure you are not developing diabetes. If you have diabetes, corticosteroid medications may make it worse and require increased treatment.

  • Exercise. First, talk with your caregiver about what would be OK for you to do. Aerobic exercise (which increases your heart rate) is often suggested. It includes walking. This type of exercise is good because it helps prevent bone loss. It also helps control your blood pressure.

  • Follow a healthy diet. Include good sources of protein in your diet. Also include fruits, vegetables and whole grains. Your caregiver can refer you to an expert on healthy eating (dietitian) for more detailed advice.

  • Learn as much as you can about vasculitis. Understanding your condition can help you cope with it. Coping can be hard because this may be something you will have to live with for years.

  • Consider joining a support group. It often helps to talk about your worries with others who have the same problems.

  • Tell your caregiver if you feel stressed, anxious or depressed. Your caregiver may refer you to a specialist, or recommend medication to relieve your symptoms.

SEEK MEDICAL CARE IF:

  • The symptoms that led to your diagnosis return.

  • You develop worsening fever, fatigue, headache, weight loss or pain in your jaw.

  • You develop signs of infection. Infections can be worse if you are on corticosteroid medication.

  • You develop any new or unexplained symptoms of disease.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your eyesight changes.

  • Pain does not go away, even after taking medication.

  • You feel pain in your chest or abdomen.

  • You have trouble breathing.

  • One side of your face or body becomes suddenly weak or numb.

  • Your nose bleeds.

  • There is blood in your urine.

  • You develop a fever of more than 102° F (38.9° C).