Vasculitis is inflammation and irritation of the blood vessels. There are several specific types of vasculitis, which are grouped by size into three groups – small-, medium-, and large-vessel vasculitis. Most types of vasculitis are autoimmune diseases, meaning they are caused by an abnormal overreaction of white blood cells to normal cells and proteins in the body. Sometimes autoimmune vasculitis happens spontaneously for no apparent reason, and other times an infection, cancer, or drug abuse precedes it.
Vasculitis can be very tricky to diagnose because its symptoms are not very specific. Vasculitis can affect anyone, but some types of vasculitis are more common in certain groups of people.
The specific symptoms of vasculitis depend on the location of the inflamed blood vessels. Some general symptoms include:
Another major feature of vasculitis is bleeding, and this will occur in whatever body part is affected. There may be reddish-purple splotches of blood on the skin (called purpura), or coughing up blood in the lungs, or blood in the urine, and more.
As an autoimmune disorder, vasculitis happens when your immune system and white blood cells improperly attack your own blood vessels. The exact reason this happens is not yet known, although genetics are thought to play a part in some types. For other types of vasculitis, severe diseases like HIV and HCV may trigger it.
Risk factors for vasculitis include:
A doctor will start by taking the history of your symptoms and performing a physical examination. The physical exam might show some features like pain or bleeding, that hint towards vasculitis. Blood tests are usually done next, because certain immune markers in the blood can indicate the presence of vasculitis. After this, imaging studies like X-rays, ultrasounds, CT-scans, and angiography (imaging of the blood vessels) may show more details of the location and severity of the vasculitis.
Vasculitis usually cannot be cured, although some types fade away and resolve on their own, with time. For other types of vasculitis, the treatment involves reducing inflammation and preventing symptoms. One of the most classic vasculitis treatments is a medication called a steroid, which can either be given as a pill or injected. Steroids reduce inflammation, reduce the overactivity of white blood cells, and can relieve a lot of vasculitis symptoms.
Unfortunately, steroids usually provide only a temporary relief, and thus have to be taken regularly. Steroids have significant side effects, most notably weight gain, which might make another medicine a better option for long-term vasculitis treatment.
Immunosuppressants are another kind of medicine that’s used to treat vasculitis, especially more severe cases. These medicines also tend to have a lot of toxic side effects, and must be taken carefully, with the instruction of a doctor.
Finally, surgery may be needed to treat vasculitis if the inflammation of the blood vessel has significantly damaged the vessel walls. Sometimes vasculitis can weaken blood vessels to the point of causing an aneurysm along the wall, and these may need to be repaired surgically.