Vasculitis: Types, Symptoms, Diagnosis and Treatment
Vasculitis, a group of diseases, causes inflammation in the blood vessels and results in weakening, thickening, narrowing or scarring of blood vessels. There are various types of vasculitis, and most of the types are rare. The causes of vasculitis are generally unknown. Vasculitis falls under autoimmune disease category in which the healthy blood vessels are attacked by the immune system for some reasons.
Types of Vasculitis
The different types of diseases that belong to vasculitis are often similar in some aspects; these are mostly different in respect to the affected organ. The types of vasculitis are categorized based on the location and size of the affected blood vessels. Following are the different types of vasculitis based on the size of affected blood vessels:
- Small vessel: Churg–Strauss syndrome, Behçet’s syndrome, cutaneous vasculitis, Henoch–Schönlein purpura, Granulomatosis with polyangiitis, microscopic polyangiitis, Golfer’s vasculitis, cryoglobulinemia
- Medium vessel: Cutaneous vasculitis, Buerger’s disease, polyarteritis nodosa, Kawasaki disease
- Large vessel: Takayasu’s arteritis, polymyalgia rheumatic, temporal arteritis, and giant cell arteritis
Symptoms of Vasculitis
- Skin: Clusters of small dots, red or purple or spots or bumps, bruises, blemishes, hives, itching
- Joints: Pain or arthritis in joints
- Lungs: Coughing up blood and breath shortness
- Digestive tract: Mouth sores, stomach pain, and in case of severe vasculitis, rupturing or weakening of intestines due to blocked blood flow to the intestines
- Ear, nose and throat: Chronic middle ear infections, sinus, sores in the nose, in severe cases, hearing loss
- Eyes: Red, burning or itchy eyes, blurred vision, light sensitivity, blindness in rare cases
- Brain: Headaches, difficulty in thinking clearly, alerted in mental status, stroke-like symptoms, eg, paralysis and muscle weakness
- Nerves: Tingling, numbness, and weakness in different body parts, feeling the loss of strength in hands and feet; sharp pains in arms and/or legs
- Blood tests: Blood tests are done to look for the inflammation signs, eg, increased level of C-reactive protein. Blood tests (eg, anti-neutrophil cytoplasmic antibodies test) look for certain antibodies that can help to diagnose vasculitis.
- Imaging tests: Imaging test including positron emission tomography (PET), X-rays, computerized tomography (CT), ultrasound, magnetic resonance imaging (MRI) are performed to look for the affected blood vessels and organs.
- Urine tests: This test is done to look for red blood cells or too much protein in the urine.
- Angiography (X-rays of blood vessels): It is done by inserting a flexible catheter into a large vein or artery in the arm or groin. A special dye, contrast medium, is then injected through the catheter, and X-rays scans (angiogram). Angiogram shows the outlines of blood vessels through which the dye travels. With this test, blocked or narrowed blood vessels are detected.
- Biopsy: In this surgical procedure, the doctor removes a small tissue from the affected area to examine for signs of vasculitis.
Treatment depends upon the affected organs or blood vessels and severity of the disease. As this is an autoimmune system, treatment mainly given to suppress the immune system response and reduce the inflammation of the blood vessels. Commonly prescribed medicines include disease-modifying antirheumatic drugs and corticosteroids.
- Disease-modifying antirheumatic drugs: Azathioprine, cyclophosphamide, and methotrexate are prescribed in severe cases to destroy inflammation-causing cells.
- Corticosteroids: Prednisone, methylprednisolone, and prednisolone are helpful in reducing inflammation.