What is Vasculitis and What are Various Ways of Treating Vasculitis?

What is vasculitis?

Vascultitis is a medical term referring to inflammation of blood vessels. The blood vessels are collectively referred to as the vascular system. The arteries present in these blood vessels supply oxygen-rich blood to various organs and tissues of the body. Vasculitis causes inflammation and thus damage blood vessel walls. The walls of the blood vessels may become weak, narrow, and increase in size due to inflammation. These changes cause a restriction in the flow of blood, which results in tissue or organ damage. This condition is especially serious because it can affect people of all ages.

What are the various types of vasculitis?

Because the vascular system is responsible for transporting oxygen through the blood to all parts of the body, vasculitis can affect any part of the body. Certain age groups are more prone to becoming affected more of than others. Vasculitis can affect one organ or it may involve several. The different type of vasculitis is mentioned below as per the size and location of the blood vessels:

• Behcet’s disease – A leading cause of blindness affecting both males and females, Behcet's commonly involves small to medium-sized blood vessels.
• Kawasaki disease – A rare type of vasculitis affecting mostly children. The symptoms usually begin with a fever, which stays for at least five days despite the medications. This disease affects the mucus membranes, walls of the blood vessel, and can also cause inflammation of blood vessels present in the coronary arteries.
• Hypersensitivity Vasculitis – It is used to describe different types of vasculitis related to skin disorders or allergies.
• Central Nervous System – An inflammation of blood vessel walls in brain or spine.
• Rheumatoid Vasculitis – Inflammation in rheumatoid vasculitis spreads to small, medium and rarely large blood vessels. The walls become thickened and lumens narrow down to the point of blockage. Multiple organs get affected and can also cause death.
• Polymyalgia Rheumatica – Inflammatory condition which affects large joints and other joints structure such as bursa. Symptoms involve stiffness and pain in shoulders, hips, and neck. Patients with this type of vasculitis may develop large blood vessels of the body.
• Buerger’s Disease – Also known as thrombo-angiitis obliterans, Buerger’s disease causes inflammation and clotting to medium sized arteries and veins, which lead to the reduction in blood supply. If more severe, then it can cause gangrene or ulcers.

What are the various causes of vasculitis?

Certain virus attacks may be the cause of vasculitis and at times the cause of it is unknown. Very rarely it may be an allergic reaction or side effect of any medication taken. However, possible causes for this reaction include:

• Drug reaction
• Hepatitis B and hepatitis C infections
• Blood cancer
• Diseases such as lupus, rheumatoid arthritis, and scleroderma

Does vasculitis develop any complications?

Vasculitis at times may be quite mild, and requiring no treatment; however at times it may get serious if it starts affecting critical organs of the body. Below are the complications of vasculitis if the symptoms are ignored:

Damage to the organ – Vasculitis at times can be so severe that it can cause permanent damage to the organ.

Loss of vision – If arthritis is left untreated then blindness is a possible complication.

Blood clots - When the blood vessels become weak it may then increase in size or bulge, also called as an aneurysm. The blood vessel walls become so weak that it ruptures and causes bleeding leading to the death. However, such instances are very rare.

What are the symptoms of vasculitis?

Since vasculitis affects any tissue or organ of the body there are the enormous number of signs and symptoms.

• If skin is affected, there is a possibility of rash appearing, ulcers or skin discolor.
• Vasculitis in the brain can lead to stroke, seizures, severe headache, paralysis, and numbness.
• Vasculitis in the heart can lead to heart attack or congestive heart failure.
• If the kidney is affected, it can lead to progressive kidney failure. This can be noted in urine tests.

Below are a few general symptoms of vasculitis:

• Loss of energy
• Loss of appetite
• Fever
• Weight loss
• Fatigue
• Headache
• Numbness or weakness
• General ache or pain
• Muscle pain
• Shortness of breath or a cough

Any unusual symptoms should be reported to the doctor to avoid complications.

Mention the diagnosis available for vasculitis:

The doctor will start by checking your medical history to ascertain whether your family has a history of vasculitis, and at the same time will start performing a physical examination.  There are certain diagnostic tests which one must undergo:

• Blood Tests – This test looks in for certain antibodies. It can be used to check for any symptoms of inflammation, such as high level of C- reactive protein. The anti-neutrophil cytoplasmic antibodies test is useful to diagnose vasculitis.

• Urine Test –It reveals whether your urine contains red blood cells or too much protein.

• Angiography or Blood vessel X-ray – A flexible catheter is inserted into a large artery or vein. A special dye is then injected through this catheter and X-rays are taken. The dye fills the arteries and veins. Your X-ray shows the outlines of the blood vessels.

• Imaging Tests – Helps to determine the affected organ and blood vessels. Imaging tests for vasculitis include X-ray, CT (computerized tomography) scan, MRI (magnetic resonance imaging) and ultrasound.

• Biopsy – A surgical procedure is carried out wherein a small sample of tissue is removed from the affected area of the body. This is then examined for any symptoms of vasculitis.

What is the various treatment for vasculitis?

Similar to the symptoms, the treatment also is dependent on the type of vasculitis the person has, which organs are affected, and the severity of the condition once diagnosed. If it is an allergic reaction or mild vasculitis, then it will go away on its own or through over the counter medication; however when critical organs are affected, timely treatment is necessary. The treatment is completely focussed on controlling the inflammation and resolving the underlying disease caused due to vasculitis.

There are two main types of treatment phases one may go through to treat vasculitis. Firstly, stopping the inflammation, and secondly, the maintenance phase or therapy. Corticosteroids and cytotoxic medicines are common prescriptions suggested to treat vasculitis.

• Corticosteroids Medication - Inflammation in blood vessels is reduced with the help of corticosteroids medication. Few examples of this medication are prednisone, methylprednisolone, and prednisolone. There can be serious side effects of these medications if taken for a longer duration. Side effects include weight gain, bone thinning and diabetes.

• Cytotoxic Medication - In case corticosteroids do not work well in curbing vasculitis or if the condition is severe then the doctor may prescribe cytotoxic medicines or immunosuppressant drugs. Certain examples of the same are methotrexate, cyclophosphamide, and azathioprine. These medications kill the cells that cause inflammation. There are certain side effects of cyclophosphamide such as the risk of infection, cancer, and infertility.

• Rituximab – One of the safe and effective option to treat certain types of vasculitis. It is a good option for maintenance therapy. One of the side effects involves a high risk of reactivating hepatitis B.

• Surgery may also be suggested by the doctor for certain type of vasculitis, especially in cases of the abnormal bulge in the wall of the blood vessel.

Apart from medications and surgery one should also adopt a healthy lifestyle to prevent such diseases.

Ensure to eat healthy – Planning your diet well can reduce the number of health related issues. The diet should mainly emphasise vegetables, fruits, low fat dairy products, lean meat, whole grains, and fish.

Stay Active – Regular walking, exercises, yoga etc. can go a long way in helping prevent bone loss, high blood pressure, or diabetes. Keeping yourself active also maintains a healthy heart and lungs.