Inflammatory Blood Vessel Disease Mimics Common Illnesses

Inflammation is a natural and essential part of the body’s immune response to injury. But sometimes inflammation goes into overdrive, and instead of helping it hurts. This type of painful chronic inflammation shows itself in many ways that are increasingly common as we age. Examples include inflammatory joint conditions such as rheumatoid arthritis and osteoarthritis; inflammatory skin conditions such as dermatitis and psoriasis, and inflammatory lung conditions such as bronchitis and pneumonia. A lesser known, but no less debilitating example of inflammation is vasculitis, a condition characterized by chronic inflammation of the blood vessels.

There are more than 30 types of vasculitis, and they produce a wide range of symptoms, depending on the area of the body that is affected. For instance, when blood vessels in the head are affected, the result may be migraine-like headaches caused by a form of vasculitis known as temporal arteritis or giant cell arteritis (GCA). GCA occurs most commonly 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. If not managed properly, vasculitis can be severe and even fatal.

“The symptoms of vasculitis can vary, though many people have fatigue, joint and muscle pain, and rashes,” says Lindsay Lally, MD, a rheumatologist at the Weill Cornell-affiliated Hospital for Special Surgery. “Vasculitis can mimic other conditions, such as infections, so seeing your internist to get the evaluation process started is imperative.”

Autoimmune Disease

Autoimmune diseases—which are more prevalent in women and are often associated with chronic inflammation—are among the factors responsible for vasculitis. Examples of autoimmune diseases that sometimes include inflammation of the blood vessels include systemic lupus erythematosus (SLE), which primarily affects the skin, joints, and kidneys; Sjögren’s syndrome, which is characterized by inflammation of the salivary and tear glands; and scleroderma, a connective tissue disorder that may involve inflammation and fibrosis of the skin and internal organs.

Vasculitis Red Flags

Vasculitis can present with a wide range of symptoms, and many of these symptoms can also be associated with other medical conditions. Here are some potential red flags:

Vision changes: GCA can cause visual disturbances, including sudden vision loss. Abrupt changes in vision should be promptly addressed by a physician.

Fatigue and weakness: Persistent fatigue and weakness not easily explained by other factors may be a symptom of systemic vasculitis affecting multiple organs.

Fever and weight loss: Unexplained fever, along with unintentional weight loss, can be indicative of systemic inflammation, which is a common feature of vasculitis.

Muscle and joint pain: Joint and muscle pain and stiffness may be present in some types of vasculitis, such as rheumatoid vasculitis.

Skin changes: Rashes, ulcers, or nodules can occur in certain types of vasculitis.

Numbness or tingling: Peripheral neuropathy, which can cause numbness, tingling, or weakness in the limbs, may be associated with vasculitis affecting smaller blood vessels.

Treatments and Side Effects

“Many of the therapies we use to treat vasculitis have significant potential for side effects, including suppressing the immune system, so an accurate diagnosis and close monitoring during therapy is crucial,” says Dr. Lally. Many medications used to treat vasculitis—such as corticosteroids, which are used to control inflammation, can cause weight gain, bone loss, and severe fatigue. Some newer treatments are associated with less intense side effects. “Some of the new therapies for vasculitis—such as tocilizumab (Actemra) for GCA—seem to improve quality of life for patients while also effectively treating the disease, which is so important,” says Dr. Lally.

Managing Vasculitis

If you are diagnosed with vasculitis, work closely with your health-care team to receive effective management. Adherence to check-up schedules and treatment plans is key to living well with the condition. Some forms of vasculitis disappear over time, while others remain for the rest of an individual’s life. Many women with systemic vasculitis report increased fatigue and pain even when the vasculitis appears to be in remission. “We encourage our patients with vasculitis to exercise regularly, eat a healthy diet, and get adequate sleep,” says Dr. Lally.

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