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Vasculitis

Overview

Vasculitis is the medical term for inflammation of the blood channels. In vasculitis, the immune response targets healthy blood vessels, leading to their expansion and constriction. Although the cause is frequently unknown, an illness or drug may cause this. Vasculitis can vary from a modest skin issue to a more severe condition that affects organs such as the heart and kidneys. Reduced blood flow may cause organ and tissue deterioration. Anyone can develop vasculitis, but some types are more prevalent in particular age categories

Types

Buerger's disease

The arteries and vessels in the legs and arms are affected by Buerger's disease. Blood clots, or thrombi, cause the blood channels to enlarge and clog, eventually harming or killing healthy tissue. This can occasionally result in infection and necrosis. Regular smoking is connected to a higher likelihood of Buerger's illness. Initial signs of poor blood circulation during exercise are frequent discomfort in the hands and feet.

Giant cell arteritis (GCA)

Only older individuals, those older than 50, have GCA, which can result in enlargement and hardening of the temporal arteries found on either side of the head. One typical sign of GCA is a new, ongoing headache. With corticosteroids, GCA symptoms rapidly improve. It is possible to lose eyesight if GCA interferes with blood circulation to the eye. Rapid GCA diagnosis and therapy can stop vision loss.

Behcet's disease

Behçet's disease is a chronic inflammatory disorder brought on by inflammation of the blood channels, which will harm and impair your veins and arteries. The primary signs are frequent mouth and genital sores, joint pain, skin problems, and eye involvement. Your doctor may advise using specific eye drops, mouthwashes, and skin creams to treat this disorder and the symptoms. You may be advised to take steroids or immunosuppressants, but it depends on the severity of your problem.

Henoch-Schonlein purpura

Capillary inflammation causes skin rashes, notably on the hips and lower legs. Capillary inflammation also commonly occurs in the kidneys. It is linked to arthritis and can occasionally cause stomach cramps.

Churg-Strauss syndrome

Vacuities of this kind typically impact a person in their 30s to 40s. It may result in asthma, allergy symptoms like cold, fever, and severe joint and muscular discomfort. It can also cause extreme tiredness, appetite loss, and weight loss.

Additionally, it can occasionally harm the renal or heart muscles and nerves, resulting in numbness, weakness, or tingling sensations. Churg-Strauss syndrome is uncommon and incurable. Typically, steroid medications are used to treat it. Peripheral nerve injury is one complication that might occur, depending on the organs involved. It can cause inflammation of the heart's outer membrane as well as kidney injury.

Cryoglobulinemia

Hepatitis C infections are associated with this disease. It is characterized by abnormal protiens clumping together when exposed to cold temperatures, clogging the vessels, and restricting the blood flow.

Kawasaki disease

The etiology of this unusual syndrome is unclear. All across the body, along with the coronary arteries that feed oxygen to the heart, it induces inflammation in the arterial walls. High fever, reddened eyes, lips, and mouth, swollen gums, and bright red patches on the feet and hands are all symptoms of Kawasaki’s disease.

Takayasu's Arteritis

This is a rare form of vasculitis when the aorta, the major artery that carries oxygen-rich blood to the entire body, is damaged by inflammation.

Causes

Although the precise reason is typically unclear, it is evident that the immune system plays a significant role. The immune system normally defends the body, but it can occasionally become "hyperactive" and start attacking certain bodily components. In the majority of vasculitis, something in the blood channel walls triggers an immunological response. Antigens are substances that trigger allergic responses. This process can occasionally be initiated by specific medications or disorders acting as antigens.

Risk Factors And Epidemiology

·         Age: Some disorders are more common in certain age groups

·         Family history

·         Lifestyle

·         Medications

·         Infections

·         Low immunity 

·         Sex

The greatest incidence of primary systemic vasculitis (6/100,000) occurs in those 65 to 74 years old. Giant cell arteritis affects 53 per 100,000 Caucasians over the age of 70.

Signs And Symptoms

Typical signs include:

·         A skin rash

·         Generalized weakness

·         Fever

·         Joint aches

·         Abdominal pain

·         Frothy urine with a dark color

·         Numbness and tingling 

·         Coughing or trouble breathing

Diagnosis

Your doctor will examine you medically and inquire about your history. To check for inflammatory conditions or rule out some other conditions, you'll require testing.

Blood tests

Antibodies or certain blood cell types may indicate vasculitis.

Urine Test

These examine protein in the urine to rule out renal injury or failure.

Imaging

Inflammation in your blood channels and organs can be seen on X-rays, ultrasounds, MRI scans, and CT scans. Additionally, your doctor may do an angiography, during which they would administer a dye to your blood. It is visible on X-rays, which provide a clearer image of your blood channels.

Echocardiogram

It is a heart scan. Using this scan, your heart's structure and functionality can be examined.

Biopsy

A tissue sample is taken from an organ or blood channel by your physician. An expert can examine it to look for inflammation or injury.

Treatment

The treatment will depend on the kind and intensity of your vasculitis, the organs affected, and any additional health conditions you may have.

Medications

Steroids

Inflammation is reduced by using these medications. Prednisone and methylprednisolone are some examples. They could adversely result in bone weakening, hyperglycemia, heartburn, and weight gain. You'll probably be given the lowest effective dose of a corticosteroid if it's required for longer treatment.

Immunosuppressant medications

Depending on the kind of vasculitis present, a different drug may be prescribed. These drugs could be rituximab, mycophenolate, cyclophosphamide, tocilizumab, azathioprine, methotrexate, or azathioprine.

Procedure

An aneurysm, which is a protrusion or balloon in a blood vessel's wall, can occasionally be brought on by vasculitis. This protrusion may require surgery to lower the chance that it will rupture. To regain blood circulation to the affected part, blocked vessels may also need to be surgically treated.

Prognosis

In some cases, vasculitis can be treated quickly. In others, the condition progresses to chronic disease that is frequently characterized by brief states of recovery, during which therapies substantially reduce clinical symptoms, followed by intervals during which the treatments lose their effectiveness and symptoms return.

Lifestyle Modifications

Find out as much as possible about vasculitis and how to treat it. Your treatment regimen may require frequent doctor visits, additional testing, and blood pressure monitoring.

Maintaining a healthy diet might help avoid harmful side effects from your drugs, such as bone weakening, hypertension, and diabetes. If you're on a corticosteroid medication, check with your doctor if you need to use a vitamin D and calcium supplement.

Maintain immunization records, particularly for pneumonia and flu. Regular cardiovascular activity, such as a walk, might help avoid the potential side effects of corticosteroid use, such as bone loss, hypertension, and diabetes.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on June 02, 2023.

References

Vasculitis (rheumatology.org)

https://rheumatology.org/patients/vasculitis

Vasculitis (arthritis.org)

https://www.arthritis.org/diseases/vasculitis