What Is Vasculitis?
Vasculitis is a general term for several conditions that cause inflammation in your blood vessels. It’s also called angiitis or arteritis. It can make your blood vessels weak, stretched, bigger, or narrower. They might close entirely.
Vasculitis can affect people at any age. Some forms affect blood vessels that go to or supply specific organs like your skin, eyes, or brain. Other kinds might involve many organ systems at the same time. Some of these general forms could be mild and not need treatment. Others may be severe.
Doctors don’t know what causes many cases of vasculitis. It might be linked to an allergic reaction to a medication. You can also get it after having an infection that sets off an unusual response in your immune system, damaging your blood vessels.
Vasculitis also may be tied to immune system diseases that you’ve had for months or years, such as rheumatoid arthritis, lupus, or Sjögren's syndrome.
Vasculitis can be serious. When your blood vessel becomes weak, it might stretch and bulge (called an aneurysm). It might also burst open, causing bleeding. This can be life-threatening but is very rare.
When your blood vessel becomes inflamed and narrowed, it might partially or totally block the blood flow to that area of your body. If you don’t have enough other blood vessels to supply the area, the tissue will die. This can happen in any part of your body.
Vasculitis can have general symptoms like fever, loss of appetite, weight loss, and fatigue.
It can also cause specific problems, depending on the body part that’s involved. If it’s your skin, you might have a rash. If your nerves aren’t getting enough blood, you could have numbness and weakness.
Vasculitis in your brain may cause a stroke. You could have a heart attack if it affects your heart. Inflammation in the vessels supplying blood to your kidney can lead to kidney failure.
If you notice anything unusual, see your doctor right away.
Types of vasculitis
Doctors divide vasculitis into types, based on the size of the blood vessels involved:
- Large. This includes conditions like polymyalgia rheumatica, Takayasu’s arteritis, and temporal arteritis.
- Medium. Examples are Buerger’s disease, cutaneous vasculitis, Kawasaki disease, and polyarteritis nodosa.
- Small. This includes Behcet’s syndrome, Churg-Strauss syndrome, cutaneous vasculitis, Henoch-Schonlein purpura, microscopic polyangiitis, granulomatosis with polyangiitis, golfer’s vasculitis, and cryoglobulinemia.
Your doctor will ask about your medical history and do a physical exam. You’ll need tests to look for inflammation or to rule out other conditions. These may include:
- Blood tests. Certain types of blood cells or antibodies can be signs of vasculitis.
- Urine tests. These check for kidney damage.
- Imaging tests. X-rays, MRI scans, CT scans, PET scans, and ultrasounds show inflammation in your blood vessels and organs. You might also have an angiogram, in which your doctor injects dye into your bloodstream. It shows up on X-rays to give a better picture of your blood vessels.
- Heart tests. An echocardiogram tests how well your heart is working.
- Biopsy. Your doctor takes a sample of tissue from your blood vessel or organ. A specialist can check it for signs of inflammation or damage.
Treatment depends on what’s causing your vasculitis and which organs are affected. Vasculitis might go away on its own if it’s the result of an allergic reaction. But if crucial organs such as your lungs, brain, or kidneys are involved, you need treatment right away.
Your doctor will probably give you corticosteroid medications, also known as steroids, to fight inflammation. You might need to take them for a long time. Your doctor will watch you closely for side effects like high blood pressure, high blood sugar, and bone problems.
Other medications can help slow your immune system with milder side effects than steroids. These include methotrexate (Rheumatrex,Trexall).
A drug called tocilizumab (Actemra) blocks an inflammatory protein in your body. You might be able to use a lower dose of steroids if you take it at the same time.
If you have anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, your doctor may prescribe avacopan (Tavneos).
Your outlook will depend on several things, including the type of vasculitis you have and how quickly you were diagnosed. With the right treatment, many people live long, productive lives.
Once your vasculitis is under control, your doctor will slowly stop your medications. The goal is for you to be in remission -- when there aren’t any signs of the condition in your body -- or to be cured. You’ll need regular checkups to watch for long-term side effects of treatment, vasculitis flare-ups, and complications. Know the symptoms so you can alert your doctor right away.