What is vasculitis?
Vasculitis is an inflammation of the blood vessels. It occurs when the immune system mistakenly attacks the blood vessels, either by infection, medication or other disease. This can restrict blood flow and cause damage to organs and tissues.
It is a condition that can affect veins, arteries and capillaries. When a blood vessel becomes inflamed it can:
- Make it more difficult for blood to pass through, by narrowing.
- Close off completely, so that blood cannot pass through.
- Stretch and become so weak that it bursts, which is called an aneurysm and can cause dangerous bleeding inside the body.
There are many types of vasculitis and most of them are rare. However, it can affect one organ or several, and can be long-lasting (chronic) or short-lasting (acute). It is a pathology that can affect anyone, although there are some types that are more common in some groups of people and in those who suffer from certain diseases.
Types of vasculitis, according to the vessels affected are:
- If it affects the larger arteries (aorta and main branches): giant cell arteritis, Takayasu arteritis, aortitis in spondyloarthropathy, isolated aortitis and aortitis in Cogan’s syndrome.
- If it affects medium-sized arteries: Polyarteritis nodosa and Kawasaki disease.
- If it affects small and medium-sized arteries: ANCA-related vasculitis, granulomatosis with polyangiitis, microscopic polyangiitis, primary vasculitis of the central nervous system and eosinophilic granulomatosis with polyangiitis.
- If small arteries are involved: lgA vasculitis (Henoch-Schönlein purpura), vasculitis associated with rheumatoid arthritis, vasculitis associated with systemic lupus erythematosus and Sjörgen’s syndrome, anti-GBM disease (Goodpasture’s syndrome), cryoglobulinemic vasculitis and drug-induced vasculitis.
- If arteries and veins of different sizes are affected: relapsing polychondritis and Behçet’s disease.
Vasculitis is an infection of the blood vessels that occurs when the immune system attacks the blood vessels.
when the immune system attacks the body itself.
Prognosis of the disease
Vasculitis can be lifelong or short-term. Specialists focus on preventing irreparable damage to vital organs (brain, lungs and kidneys, for example) and nerves. They will also try to prevent the patient’s death and disability. However, it is true that the symptoms of vasculitis can affect the patient’s life (fatigue, pain, arthritis, etc.). In addition, the side effects of certain medications can influence and make the patient more vulnerable to certain infections.
Symptoms of vasculitis
The symptoms of vasculitis are usually fever, fatigue, headache, general condition of the patient, skin rash, night sweats, weight loss and local clinical manifestations in some parts of the body, as blood flow decreases. This results in ischemia or visceral infarction due to occlusion of blood vessels, causing abdominal pain, renal failure, neurological symptoms, among other symptoms.
Medical tests for vasculitis
The specialist may suspect vasculitis if the patient shows unusual symptoms and findings during the physical examination. Diagnosis of the disease will be made by tissue biopsy, angiography to detect abnormalities in the blood vessels and blood tests. These tests will help diagnose each type of vasculitis based on the size of the blood vessels and the organs that are affected.
What causes vasculitis?
There is no known exact cause of most vasculitis. There are genetic factors that may play a role and it is also considered to be an autoimmune disease, whereby it is the immune system itself that attacks the body, in this case the blood vessels. In other vasculitides it is caused by chronic infections (hepatitis B or C, for example). It is also the result of reactions to certain medications.
On the other hand, it can be part of other rheumatic diseases: systemic lupus erythematosus, rheumatoid arthritis and Sjörgen’s syndrome. However, most patients with vasculitis do not have rheumatic pathologies.
Can it be prevented?
Vasculitis can appear at any age and affect people of any race or sex. However, there are factors that can increase the risk of vasculitis, such as:
- Suffering from chronic hepatitis B or C diseases.
- Suffering from autoimmune diseases such as scleroderma, lupus or rheumatoid arthritis.
- Smoking.
Treatments for vasculitis
Vasculitis should be treated primarily with glucocorticoids, also called steroids. These are drugs that help reduce inflammation but may have side effects. Sometimes immunosuppressive treatments are also recommended, as the side effects are less severe. These treatments are usually used for rheumatic diseases but can also be used to treat vasculitis.
Vasculitis may cause severe damage to some parts of the body or organs. In such cases, surgery will sometimes be recommended. The intervention will depend on where the damage is and how severe it is. Thus, a bypass graft (surgery that reduces blood flow around the blood flow blockage) may be helpful, as well as sinus surgery or a kidney transplant.
Which specialist treats it?
It is usually rheumatology specialists who treat vasculitis, directing attention to patients with chronic disease. However, patients with vasculitis should also consult the specialists who treat the organs that are affected. Thus, patients with vasculitis can also be seen by specialists in Angiology and Vascular Surgery, Internal Medicine, Dermatology, Neurology, Ophthalmology, Otorhinolaryngology, Nephrology or even Pneumology.