Vasculitis

Vasculitis can affect arteries, veins and capillaries. Arteries are vessels that carry blood from the heart to the body’s organs. Veins are the vessels that carry blood back to the heart. Capillaries are tiny blood vessels that connect the small arteries and veins.

When a blood vessel becomes inflamed, it can

• Narrow, making it more difficult for blood to get through
• Close off completely so that blood can’t get through
• Stretch and weaken so much that it bulges. The bulge is called an aneurysm. If it bursts, it can cause dangerous bleeding inside the body.

Symptoms of vasculitis can vary, but usually include fever, swelling and a general sense of feeling ill. The main goal of treatment is to stop the inflammation. Steroids and other medicines to stop inflammation are often helpful.

Prevention

You can’t prevent vasculitis. However, treatment can help prevent or delay the complications of vasculitis.

Risk Factors

Vasculitis can affect people of all ages and races and both sexes. Some types of vasculitis seem to occur more often in people who:

• Have certain medical conditions, such as chronic hepatitis B or C infection
• Have certain autoimmune diseases, such a lupus, rheumatoid arthritis, and scleroderma
• Smoke

Causes

Vasculitis occurs if your immune system attacks your blood vessels by mistake. What causes this to happen isn’t fully known.

A recent or chronic infection may prompt the attack. Your body also may attack its own blood vessels in reaction to a medicine.

Sometimes an autoimmune disorder triggers vasculitis. Examples of these disorders include lupus, rheumatoid arthritis, and scleroderma. You can have these disorders for years before developing vasculitis.

Vasculitis also may be linked to certain blood cancers, such as leukemia and lymphoma.

Symptoms

The signs and symptoms of vasculitis vary. They depend on the type of vasculitis you have, the organs involved, and the severity of the condition. Some people may have few signs and symptoms. Other people may become very sick.

Sometimes the signs and symptoms develop slowly, over months. Other times, the signs and symptoms develop quickly, over days or weeks.

Common signs and symptoms of vasculitis are:

• Fever
• Loss of appetite
• Weight loss
• Fatigue
• General aches and pains

If vasculitis affects your skin, you may notice skin changes. For example, you may have purple or red spots or bumps, clusters of small dots, splotches, bruises, or hives.

If vasculitis affects your joints, you may ache or develop arthritis in one or more joints.

If vasculitis affects your lungs, you may feel short of breath. You may even cough up blood. The results from a chest x ray may show signs that suggest pneumonia, even though that may not be what you have.

If vasculitis affects your gastrointestinal tract, you may get ulcers in your mouth or have stomach pain. In severe cases, blood flow to the intestines can be blocked. This can cause the wall of the intestines to weaken and possibly rupture. A rupture can lead to serious problems or even death.

If vasculitis affects your sinuses, nose, throat, and ears, you may have sinus or chronic (ongoing) middle ear infections. Other symptoms include ulcers in the nose and, in some cases, hearing loss.

If vasculitis affects your eyes, you may develop red, itchy, burning eyes. Your eyes also may become sensitive to light, and your vision may blur. Rarely, certain types of vasculitis may cause blindness.

If vasculitis affects your brain, symptoms may include headaches, problems thinking clearly, changes in mental function, or stroke-like symptoms, such as muscle weakness and paralysis.

If vasculitis affects your nerves, you may have numbness, tingling, and weakness in various parts of your body. You also may have a loss of feeling or strength in your hands and feet and shooting pains in your arms and legs.

Diagnosis

Your doctor will diagnose vasculitis based on your signs and symptoms, your medical history, a physical exam, and test results.

Depending on the type of vasculitis you have and the organs affected, your doctor may refer you to various specialists, including:

Blood tests can show whether you have abnormal levels of certain blood cells and antibodies in your blood.

A biopsy often is the best way for your doctor to make a firm diagnosis of vasculitis.

Treatment

Treatment for vasculitis will depend on the type of vasculitis you have, which organs are affected, and the severity of the condition.

People who have severe vasculitis are treated with prescription medicines. Rarely, surgery may be done. People who have mild vasculitis may find relief with over-the-counter pain medicines, such as acetaminophen, aspirin, ibuprofen, or naproxen.

The main goal of treating vasculitis is to reduce inflammation in the affected blood vessels. This usually is done by reducing or stopping the immune response that caused the inflammation. Common prescription medicines used to treat vasculitis include corticosteroids and cytotoxic medicines.

Recovery

The outcome of vasculitis is hard to predict. It will depend on the type of vasculitis you have, which organs are affected, and the severity of the condition.

If vasculitis is diagnosed early and responds well to treatment, it may go away or go into remission. “Remission” means the condition isn’t active, but it can come back, or “flare,” at any time.

Flares can be hard to predict. You may have a flare when you stop treatment or change your treatment. Some types of vasculitis seem to flare more often than others. Also, some people have flares more often than others.

Sometimes vasculitis is chronic (ongoing) and never goes into remission. Long-term treatment with medicines often can control chronic vasculitis, but no cure has been found. Rarely, vasculitis doesn’t respond well to treatment. This can lead to disability or even death.