What is Vasculitis?

Purpura on the low limb due to medication induced Vasculitis.Vasulitis also known as Arteritis or Angiitis is the term used to describe a set of diseases that are characterized by the inflammation of blood vessels. The inflammation may affect all sizes of blood vessels including the smallest (capillaries) and the largest (aortae). Inflammation may involve redness, pain, swelling and functional loss of the affected parts.

Moreover, the inflammation brings about changes in the walls of the blood vessels in the form of narrowing, thickening, scarring and weakening. When a blood vessel narrows down, proportionate blood flow, nutrient transport and oxygen flow are affected. In some cases, the blood vessel may shut down completely and in some other instances the vessels may bulge (aneurysm) to an extent that they burst and cause internal bleeding. Blood may clot in some people blocking the blood flow.

Vasculitis can be mild or severe affecting major blood vessels that supply blood to important organs and tissues in the body. Due to insufficient blood flow, these organs get damaged and die eventually.

What Causes Angiitis?

Although the exact cause of this condition is not known in most of the cases it is a result of the body’s own immune system attack on the blood vessels which could be a reaction to a medicine or infection or a certain cancer or a disorder of immune system.

  1. Primary VasculitisIn this type of Angiitis, the cause is unknown.
  2. Secondary Vasculitis – In this case, the underlying cause is another disease or condition. These include:
  • Allergies – People allergic to medications may develop this condition when the medicine reacts with the immune system.
  • Infections – Some people develop it as a result of an infection. For example: polyarteritis nodosa, a type of Arteritis is the result of hepatitis B virus infection. Similarly, hepatitis C virus infection causes another type of Arteritis, cryoglobulinemia.
  • Cancers of Blood Cells – Blood cell cancers such as lymphoma, leukemia etc may also cause this condition.
  • Immune system disorders – Immune system diseases such as Sjogren’s syndrome, lupus, rheumatoid arthritis etc could also result in this condition.

Vasulitis Symptoms:

Symptoms of this disease vary depending on the type of blood vessel and the organ affected. Common symptoms include:

  • Joint and muscle pain.
  • Weight loss.
  • Fever.
  • Loss of appetite.
  • Fatigue.
  • Weakness or numbness of the nerves.

Different types of this condition have been identified. The symptoms in each of these conditions also differ. These include:

  • Rheumatoid vasculitis – As the name indicates, this type worsens the already existing rheumatoid arthritis.
  • Microscopic polyangiitis – Small blood vessels of lungs, kidneys and skin are affected in this type. Symptoms include swelling of the blood vessels in kidneys, skin lesions, sudden weight loss and fever.
  • Cryoglobulinemia – A result of hepatitis C virus infection. Symptoms comprise of arthritis, purpura or rash on lower extremities, neuropathy or nerve damage and weakness.
  • Buerger’s disease – Strongly associated with cigarette smoking this condition is characterized by clotting and swelling of blood vessels in the extremities. Symptoms include ulcers on toes and fingers, pain in arms, legs and feet.
  • Giant cell arteritis – Inflammation of blood vessels in the head. Headache, blurred vision, tenderness of the scalp and pain in the jaw while chewing are the typical symptoms of this condition.
  • Hypersensitivity vasculitis – This is characterized by red spots on the skin which are usually a result of an allergy or medication or infection.
  • Wegener’s granulomatosis – Inflammation of the blood vessels in sinuses, nose, lungs, throat and kidneys constitute this condition. Symptoms include nosebleeds, shortness of breath, ear infections, chronis sinusitis and feeling stuffed in the nasal region.
  • Kawasaki disease – Children below the age of 5 years are affected by this disease whose symptoms include rashes on the skin, fever and inflammation of eyes.
  • Henoch-Schonlein purpura – In this disease, blood vessel inflammation occurs in joints, kidneys, bowel and skin. Rash or purpura on buttocks, feet and legs, pain in the abdomen and joints, and blood in urine are the symptoms of this condition.
  • Churg-Strauss syndrome – Associated with asthma, in this condition inflammation occurs in the blood vessels of lungs.
  • Behcet’s syndrome – Inflammation of arteries (blood vessels that transport blood from heart to other organs) and veins (blood vessels that bring blood from different organs to heart) occurs in this condition. Ulcers in the mouth and genitals, acne-like skin lesions on the skin and inflammation of eyes are the typical symptoms of this syndrome.
  • Takayasu’s arteritis – Young women are usually affected by this condition in which the largest arteries of the body get swollen. Symptoms include lightheadedness, visual disturbances, weakness in the arm and reduced or totally absent pulse.
  • Polymyalgia rheumatica – Characterized by inflammation of large joints like hips, shoulders and knees, this disease usually affects elderly people. Stiffness and pain in the hip muscles, shoulders, thigh muscles and neck comprise the list of symptoms.
  • Polyarteritis nodosa – Medium sized blood vessels in various body parts such as kidneys, skin, intestines, muscles and peripheral nerves are affected. Symptoms include kidney related problems, purpura, joint and muscle pain, ulcers on the skin and pain in the abdomen.

Vasculitis is diagnosed by performing several tests and procedures such as imaging, blood and urine tests, X-rays of blood vessels and biopsy (removal of a small piece of an affected blood vessel).

Treating Vasculitis:

Treatment options depend on the type of vasculitis that has affected the patient. Options include:

  • Cytotoxic drugs – These drugs are aimed at killing the cells of the immune system responsible for causing inflammation. Cytoxan (cyclophosphamide) and Imuran (azathioprine) are the two cytotoxic drugs.
  • Corticosteroids – These control inflammation in the affected region. Medrol (methylprednisolone) and prednisone are the examples of corticosteroidal drugs.

Healthy diet and regular body exercise can prevent the side effects of taking these medications.

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