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Vasculitis

Definition


Disease: Vasculitis Vasculitis
Category: Cardiovascular diseases

Disease Definition:

Also called angiitis and arteritis, vasculitis is the inflammation of blood vessels. Vasculitis has several types. Changes in the walls of the blood vessels, including thickening, weakening, scarring and narrowing results from Vasculitits. Organ and tissue damage, even death could result from the shortage of blood. Vasculitis could be short term (acute) or long term (chronic) and it could be so severe that the tissues and organs supplied by the affected vessels don’t get enough blood. Anyone could be affected by vasculitis, and some kinds of vasculitis are more common among particular groups. Some types of vasculitis need treatment such as taking medications for long periods of time; while other types may go away on their own.
 

Work Group:


Symptoms, Causes

Symptoms:

COMMON VASCULITIS SIGNS AND SYMPTOMS:

Depending on which blood vessels and, as a result, which organ systems are affected, the signs and symptoms of vasculitis differ. However, there are signs and symptoms that most people affected with this disease experience, such as: 

  • Fatigue
  • Loss of appetite
  • Weight loss
  • Weakness, numbness or other nerve problems
  • Muscle and joint pain
  • Fever

 

SIGNS AND SYMPTOMS OF EACH TYPE OF VASCULITIS:

Behcet's syndrome:

This condition usually appears in a person’s 20s and 30s, causing inflammation of the arteries and veins. Mouth and genital ulcers, eye inflammation and acne-like lesions on the skin are included in the signs and symptoms.

 

Buerger's disease:

In the blood vessels in the extremities, inflammation and clots are caused by this condition, which is also called thromboangiitis obliterans. This disorder is strongly related to cigarette smoking. Pain in the hands, arms, legs and feet, and ulcers on the fingers and toes are included in the signs and symptoms.

 

Churg-Strauss syndrome: 

This syndrome is usually associated with asthma. The blood vessels in the lungs are the ones that are most commonly affected by this condition, which is also called allergic angiitis and granulomatosis.

 

Cryoglobulinemia:

Arthritis, a rash known as purpura on the lower extremeties, nerve damage (neuropathy) and weakness are some of the signs and symptoms of this condition. Hepatitis C infections are usually associated with cryoglobulinemia.

 

Giant cell arteritis:

Polymyalgia rheumatica is usually associated with this condition. Giant cell arthritis is inflammation of the arteries in the head, especially the temples, which occurs in people older than 50. Scalp tenderness, blurred or double vision, headaches, jaw pain while chewing and blindness are some of the things that may result from this condition.

 

Henoch-Schonlein purpura:

Inflammation of the blood vessels of the skin, bowel, kidneys and joints causes this condition. Abdominal pain, joint pain, blood in the urine, and a rash named purpura on the buttocks, feet and legs are some of the signs and symptoms of this condition. Henoch-Schonlein could occur at any age, but it usually develops in children. 

 

Hypersensitivity vasculitis: 

An allergy, usually to a medication or an infection triggers this condition. Its primary sign is red spots on the skin.

 

Kawasaki disease: 

Children younger than 5 years are the ones most commonly affected by this condition. Eye inflammation, fever and skin rash are some of its signs and symptoms.

 

Microscopic polyangiitis: 

Small-sized blood vessels in the kidneys, skin and lungs are affected by this form of vasculitis. Skin lesions, unintentional weight loss, fever, glomerulonephritis (an inflammation of the small blood vessels in the kidneys) and nerve damage are some of its signs and symptoms.

 

Polyarteritis nodosa:

Medium-sized blood vessels in various portions of the body including the kidneys, skin, peripheral nerves, heart, muscles and intestines are affected by this form of vasculitis. A rash named purpura, skin ulcers, muscle and joint pain, abdominal pain and kidney problems are the signs and symptoms of this form of vasculitis.

 

Polymyalgia rheumatic: 

Causing pain and inflammation of the large joints, such as the knees, shoulders and hips, this condition mainly affects older adults. This condition usually occurs in association of giant cell arteritis. Pain and stiffness in the muscles of the upper arms, shoulders, neck, hips and thighs are some of the signs and symptoms of polymyalgia rheumatic.

 

Rheumatoid vasculitis:

Many parts of the body may be involved in this condition, including the skin, hands, feet and eyes. Rheumatoid vasculitis usually occurs in people with a history of severe rheumatoid arthritis, complicating its course.

 

Takayasu's arteritis: 

Usually occurring in young women, this type involves the largest arteries in the body, including the aorta. Headaches, decreased or absent pulses, visual disturbances, lightheadedness and arm weakness or pain (claudication) with use are some of the signs and symptoms of Takayasu’s arteritis.

 

Wegener's granulomatosis:

Inflammation of the blood vessels in the sinuses, throat, nose, kidneys and lungs is caused by this condition. Shortness of breath, frequent ear infections, chronic sinusitis and nosebleeds are included in the signs and symptoms of Wgener’s granulomatosis.

 

If someone experiences any worrisome signs and symptoms, he/she should see a doctor.
 

Causes:

When the body attacks a person’s blood vessels, vasculitis occurs. Although an infection, certain immune system disorders, an allergic reaction or some cancers might serve as the trigger, but the exact cause of this disorder is still not known. Blood vessels affected by vasculitis get inflamed, causing the thickening of the layers of the blood vessel wall. This narrows the blood vessels, decreasing the amount of blood and therefore oxygen and vital nutrients reaching the tissues of the body. Sometimes, a blood clot might form in an affected blood vessel and block the flow of blood. Occasionally, instead of becoming narrower, a blood vessel might weaken and form a bulge (aneurysm), a condition that could be potentially life-threatening. 

 

PRIMARY VASCULITIS:

Primary vasculitis is when the cause of the condition is not known. Many types of vasculitis are primary ones. 

 

SECONDARY VASCULITIS:

Secondary vasculitis is when an underlying disease is the cause of vasculitis. Secondary vasculitis may be caused by:

 

Infections:

Sometimes, an infection may result in some forms of vasculitis. For example, some cases of polyarteritis nodosa may result from an infection with the hepatitis B virus, while most cases of cryoglobulinemia result from an infection with the hepatitis C virus.

 

Immune system diseases: 

Rheumatoid arthritis, lupus and Sjogren’s syndrome are diseases of the immune system that may cause vasculitis.

 

Allergic reactions: 

Vasculitis may sometimes result from an allergic reaction to a medication. 

 

Blood cell cancers:

Vasculitis could sometimes result from cancer affecting blood cells, including leukemia and lymphoma.
 

Complications

Complications:

Depending on the type of the vasculitis complications could differ. Some of the common complications of this disease include: 

 

Organ damage: 

Some types of vasculitis can cause damage to major organs in case the condition is severe. 

 

Recurring episodes of vasculitis: 

In some cases, vasculitis might never completely disappear and need continuing treatment. While in other cases, the condition might recur and need further treatment even if treatment for vasculitis seemed to be initially successful.
 

Treatments:

The patient’s general health, the type of vasculitis and the severity of the condition are some factors that treatment for this condition depends on. Some types of vasculitis require medication, while others, such as Henoch-Schonlein purpura, are self-limiting and improve on their own. A person with vasculitis may be prescribed:

 

Steroids to control inflammation:

In order to control inflammation, doses of corticosteroid medications are used in the treatment of many kinds of vasculitis, such as prednisone or methylprednisolone. Particularly when taken over long periods of time, side effects of steroids could be severe. Weight gain, diabetes and bone thinning (osteoporosis) could be some of those side effects. The patient will receive the lowest possible dose to control the disease.

 

Medications to control the immune system:

Treatment with cytotoxic drugs that kill immune system cells responsible for causing inflammation may be needed in severe cases of vasculitis or those that don’t respond well to corticosteroids. Although mycophenolate mofetil is still being tested in clinical trials, but researchers have had some success using this immunosuppressant drug. Cyclophosphamide and azathioprine are two examples of cytotoxic drugs.
 

Prognosis:

Not available

Expert's opinion

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