Vasculitis Can Affect Any Blood Vessel In Your Body

Vasculitis is an umbrella term for a group of several diseases that can produce a wide range of symptoms, depending on the area of the body that is affected.

“Vasculitis simply means inflammation of blood vessels. Any blood vessel in the body, from large arteries to tiny capillaries, can be involved in vasculitis,” explains Lindsay Lally, MD, a rheumatologist at the Weill Cornell-affiliated Hospital for Special Surgery. “We tend to characterize vasculitis based on the caliber (size) of the blood vessel involved in the inflammatory process and by the organ systems affected. In rheumatology, we deal with primary vasculitides, for which there are no known triggers or associated conditions.” These types of vasculitis are autoimmune in nature, meaning that the body’s immune system, which is responsible for fighting off viruses, bacteria, and other potentially harmful organisms, mistakenly attacks healthy tissue.

Other types of vasculitis can be triggered by infections, drugs, or cancers.

Symptoms of Vasculitis

“In adults, the most common form of systemic vasculitis is giant cell arteritis (GCA),” says Dr. Lally. GCA affects large arteries, such as the aorta and its branches, and it may also affect the arteries in the head and neck. GCA most commonly occurs in adults over age 50 and affects women twice as often as men. The most common symptoms of GCA include headache, fever, flu-like symptoms, and joint pain. Other symptoms are blurry or double vision, scalp tenderness, and jaw pain.

Many of the symptoms of vasculitis are nonspecific; they include malaise, fatigue, rashes, fevers, and muscle weakness. In addition, these symptoms may come and go, which may lead to delays in diagnosis. Areas of the body affected by vasculitis can include the hands, feet, head, nose, sinuses, lungs, skin, kidneys, digestive tract, and nerves.

Vasculitis Can Do Damage

If you have any of these symptoms, it’s important to report them to your doctor, since some forms of vasculitis can cause irreversible damage.

“Vasculitis can result in damage and produce complications in two ways,” explains Dr. Lally. “Inflammation in the blood vessels leads to diminished blood flow or blocked vessels, resulting in ischemia (inadequate blood supply), necrosis (cell death), and subsequent tissue damage to a target organ. For example, in GCA, one feared complication is vision loss that can result from inadequate blood supply to the eye. Second, the blood vessels themselves can be damaged, resulting in permanent stenosis (narrowing), formation of an aneurysm (bulge) in the vessel, and vessel rupture.”

Diagnosis

Since many of the symptoms of vasculitis are common among a host of other medical conditions, it can be difficult to diagnose.

“The first challenge in the management of vasculitis is considering it as a possible diagnosis,” says Dr. Lally. “Usually, more common conditions, such as infections and even cancers, are ruled out before the diagnosis of vasculitis is entertained.”

If vasculitis is suspected, various tests can help determine if it is present.

Dr. Lally says that there are some forms of vasculitis where specific blood or urine tests, or scans such as magnetic resonance imaging (MRI) or computed tomography (CT) can be useful. In some cases, biopsy of an affected organ, such as a kidney or the skin, is needed to confirm a diagnosis of vasculitis.

Treatment Options

Dr. Lally explains that most forms of primary vasculitis, such as GCA, require treatment with immunosuppressive drugs that stop the body from attacking itself. Corticosteroids, such as prednisone, are often used because they work quickly to control the inflammation.

“It is an exciting time to be involved in the treatment of vasculitis because there are an increasing number of treatments available to patients,” says Dr. Lally. “For example, in May 2017, the FDA approved the first-ever treatment for GCA, a medication called tocilizumab (Actemra®). In the Scleroderma, Vasculitis and Myositis Center at the Hospital for Special Surgery, we are involved in cutting-edge research to identify new treatments for patients with various forms of vasculitis.”

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