Vasculitis is a medical term for diseases that cause injury to blood vessels by inflammation. Some forms of vasculitis may be quite mild and resolve on their own without any forms of medical therapy. Other types may involve the most critical organ systems in the body and lead to rapid deterioration and death in a short period of time. The physician must be able to distinguish the different types of vasculitis, their risk to individual organ systems and to the patient’s overall well-being. Once it is determined that vasculitis is not of the type that may go away on its own, the degree of risk to the patient must be determined and treatment selected. In the Center for Vasculitis Care and Research at the Cleveland Clinic, our physicians deal with the entire spectrum of these illnesses on a regular basis.
The most commonly encountered vasculitis in our Center is giant cell arthritis of the elderly. Wegener’s granulomatosis is the second most common form of vasculitis seen by our doctors. We are also committed to care and research for patients with microscopic polyangiitis, polyarthritis nodosa, Churg Strauss syndrome, Takayasu’s arthritis, Henoch Schonlein purpura, Kawasaki’s disease, central nervous system (brain) vasculitis and vasculitis complicating a variety of other autoimmune disorders and infections.
In some instances, a vasculitic illness may not take on the typical characteristics that allow identification in any one of these categories. Patients in this situation are said to have a “non-specific” or “overlap” form of vasculitis. The inability to provide a more precise diagnosis is often not a sign of the physician’s limitations, but a reflection of the fact that vasculitis may take on unique features in different patients and that it may take months and rarely years for a vasculitic disorder to fully express itself. Regardless of the name applied to the disease, treatment is determined based on the rate of disease progression, the particular organ system(s) involved and the physician’s impression of anticipated outcome based on the medical literature and the physician’s experience.
Although we feel that we bring unique skills and experience to the care of patients with vasculitis, this is not good enough. Most of the diseases that the reader will learn about in these pages do not have a known cause or a cure. The vasculitides are generally controllable, and in fortunate individuals, treatment will lead to longstanding remissions that may endure even in the absence of continued treatment. Unfortunately, treatment is often associated with side effects that are often unavoidable.
There is no question that modern treatments have converted many of these once fatal conditions into chronic illnesses. That is quite rewarding. However, we have many additional challenges in the future. We must find safer effective therapies. This can be best accomplished by research efforts in identifying the causes of vasculitis, which will best provide a chance to cure these illnesses. Our clinical care and research units are intended to provide you with state-of-the-art treatment, and allow us to share with you the latest advances for the future.
Carol A. Langford, M.D., M.H.S.
Director
Gary S. Hoffman, M.D., M.S.
Department of Rheumatic and Immunologic Diseases
Harold C. Schott Chair, in Rheumatic & Immunologic Diseases
Leonard H. Calabrese, D.O., FACR
Vice Chairman, Department of Rheumatic and Immunologic Diseases
R.J. Fasenmyer Chair, in Clinical Immunology
