Vasculitis

1 What is Vasculitis?

Vasculitis refers to inflammation of blood vessel, the symptoms of which range from mild to life-threatening. Symptoms vary according to the organ involved and the severity of the condition. Inflammation of the blood vessel result in stretching, weakening, thickening, and scarring. 

The vessels may increase in size or become narrow, both of which affect the flow of blood. It affects people of all age groups. There are different types of vasculitis, some of which affect only one organ while others affect many organ systems simultaneously. 

Symptoms depend on the type of vasculitis. Mild form of vasculitis may not require any specific treatment. Immunosuppression is often the prescribed treatment for vasculitis.

2 Symptoms

Signs and symptoms depend on the type of vasculitis. Generalized symptoms of the condition are: 

Symptoms of specific type of vasculitis may develop during the early stages and progress rapidly. Some other symptoms appear in the later stages of the disease.

  • Behcet's syndrome is characterized by ulcers in mouth and genital organs, inflammation of the eye, and acne
  • Buerger's disease or thromboangiitis obliterans is a type of vasculitis in which the blood vessels of hands and feet develop inflammation. Interruption of blood flow to these organs cause pain in feet and hands. It also causes ulcers in fingers and toes. This condition is linked to smoking. 
  • Cryoglobulinemia is characterized by weakness, pain in joints, and tingling. It is linked to hepatitis C infection. 
  • Churg-Strauss syndrome or eosinophilic granulomatosis with polyangiitis is another type of vasculitis that affects kidneys, lungs, and peripheral nerves. Asthma, nerve pain, and sinus infections are the main symptoms. 
  • Giant cell arteritis is the type of vasculitis in which the arteries of temple develop inflammation. It causes vision problems, headaches, jaw pain, and scalp tenderness. 
  • Wegener's granulomatosis or Granulomatosis with polyangiitis is characterized by inflammation of blood vessels in throat, lungs, kidneys, sinuses, and nose. This causes nosebleeds, stuffy nose, and nasal infections. 
  • Henoch-Schonlein purpura has inflammation of the blood vessels in skin, joints, bowels, and kidney. It is more commonly seen among children and is characterized by abdominal pain, blood in urine, joint pain, and rashes on buttocks and lower legs. 
  • Hypersensitivity vasculitis is caused by an infection or as an adverse reaction to certain medications. It causes red rashes on the lower part of the leg.
  • Kawasaki disease is a type of vasculitis seen in children under the age of 5, characterized by fever, rash, and inflammation of eye. 
  • Microscopic polyangiitis is characterized by inflammation of small blood vessels in lungs and kidneys. Abdominal pain, blood in sputum, and rashes are the common symptoms. 
  • Polyarteritis nodosa affects organ systems like kidneys, skin, nerves, and gastrointestinal system. This type of vasculitis is also associated with hepatitis infection. It causes skin rashes, pain in muscles and joints, abdominal pain, hypertension, and kidney problems. 
  • Takayasu's arteritis is more common among women and affects the larger arteries like aorta. Numbness in limbs, loss of pulse, hypertension, headache, and vision problems are the main symptoms. 

3 Causes

The actual cause of vasculitis is unknown. In some cases it is associated with infections like hepatitis. In some cases, allergic reaction to certain medications may trigger the symptoms of vasculitis. 

Rheumatoid arthritis, lupus, and scleroderma may also cause vasculitis. Inflammation of the blood vessels causes thickening of the walls, which narrows the lumen of the vessel. This affects the blood flow through the vessel.

4 Making a Diagnosis

Complete physical examination and medical history are the two initial diagnostic steps of vasculitis. Other tests and procedures include: 

  • Blood tests – indicate increased levels of C-reactive protein, which is a sign of inflammation. Anti-neutrophil cytoplasmic antibodies test measures the level of specific antibodies that show inflammation of blood vessel. 
  • Urine test – is used to screen for the presence of red blood cells or abnormal amounts of protein, both of which indicate a medical condition that lead to inflammation of blood vessel. 
  • Imaging tests – X-ray, CT scan, MRI, and PET help to visualize the structure and functioning of blood vessel. Angiography is a type of imaging technique in which a catheter is introduced into a blood vessel. The catheter is filled with a dye which spreads into the different blood vessels. The blood vessels are then visualized using X-ray. 
  • Biopsy – in this procedure a small sample of tissue is tested for abnormalities. 

5 Treatment

Controlling inflammation and underlying diseases is the most common treatment for vasculitis. It is usually done in two phases:

  • controlling inflammation,
  • preventing relapse.

Some of the common medications used in the treatment of vasculitis include:

  • Medications like prednisone or methylprednisolone are corticosteroids that help to control inflammation of blood vessels.
  • If the patient does not respond to corticosteroids, immunosuppressant drugs are prescribed. These drugs controls the functioning of immune system that cause inflammation. 
  • Azathioprine, methotrexate, and cyclophosphamide are some common drugs used for this purpose.
  • Rituximab is used for preventing relapse of vasculitis.

6 Prevention

It is not possible to prevent vasculitis. But, timely treatment helps to avoid or delay complications of vasculitis.

7 Alternative and Homeopathic Remedies

Several alternative and homeopathic remedies exist for managing the symptoms of vasculitis.

Arsenic, echinacea angustifolia, calcaria carb, kali iod, lachesis, natrum iod, secale cor, histaminum, sulfanilamidum are commonly used in homeopathy for controlling symptoms. Antioxidants are suggested in the control of inflammation. 

Anti-inflammatory diet is also recommended for controlling symptoms. Hypnosis, psychotherapy, biofeedback, guided imagery therapy, and traditional Chinese medicine are suggested in controlling emotional flare up due to the condition.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with vasculitis.

Including more fruits and vegetables, avoiding polyunsaturated vegetable oils, margarine, and trans-fatty acids help to improve inflammation. Understanding the condition and consistently following the treatment plan is very important in successfully treating the condition. 

Choosing a healthy diet and exercising regularly improve the sense of well-being. Support from family and friends helps to cope with the condition.

9 Risks and Complications

Complications are based on the type and severity of vasculitis. Blood clot, aneurysms, organ damage, blindness, and infections are some common complications of vasculitis.

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