What is vasculitis?
Vasculitis is the inflammation of the body’s blood vessels. Vasculitis can affect very small blood vessels (capillaries), medium-size blood vessels, or large blood vessels such as the aorta (the main blood vessel that leaves the heart).
When inflamed, the blood vessels may become weakened and stretch in size, which can lead to aneurysms. The vessels also may become so thin that they rupture resulting in bleeding into the tissue. Vasculitis can also cause blood vessel narrowing to the point of closing off entirely (called an occlusion). If blood flow in a vessel with vasculitis is reduced or stopped, the tissues that receive blood from that vessel become injured and begin to die.
Symptoms and Causes
What causes vasculitis?
In most cases, the exact cause is unknown; however, it is clear that the immune system (the system that keeps the body healthy) plays a big role. While the immune system usually works to protect the body, it can sometimes become "overactive" and end up attacking parts of the body. In most cases of vasculitis, something causes an immune or "allergic" reaction in the blood vessel walls. Substances that cause allergic reactions are called antigens. Sometimes certain medicines or illnesses can act as antigens and start this process.
What are the symptoms of vasculitis?
Common symptoms include:
- Skin rashes
- Joint pains
- Abdominal pain
- Kidney problems (including dark or bloody urine)
- Nerve problems (including numbness, weakness and pain)
- Cough and/or shortness of breath
Additional symptoms can occur, depending on the area of the body affected by vasculitis. If a blood vessel in the skin with vasculitis is small, the vessel may break and produce tiny areas of bleeding in the tissue. These areas will appear as small red or purple dots on the skin. If a larger vessel in the skin is inflamed, it may swell and produce a nodule (lump or mass of tissue), which may be felt if the blood vessel is close to the skin surface.
Diagnosis and Tests
How is vasculitis diagnosed?
The diagnosis of vasculitis is based on a person's medical history, current symptoms, complete physical examination, and the results of specialized laboratory tests. A doctor can test for blood abnormalities, which can occur when vasculitis is present. These abnormalities include:
- Anemia (low red blood cell count)
- A high white blood cell count
- A high platelet count
- Signs of kidney or liver problems
Blood tests also can identify immune complexes or antibodies (ways the body fights off what it thinks is a threat) that can be associated with vasculitis. Additional tests may include X-rays, tissue biopsies, blood vessel and heart scans.
Management and Treatment
How is vasculitis treated?
The precise treatment of vasculitis depends on the specific type of vasculitis and the areas/organs that are involved. Some measures that may be necessary include the use of corticosteroids, such as prednisone. For more serious types of vasculitis, other medications that suppress the immune system are also used. These medicines have their own side effects and these treatments must be watched very closely.