Vasculitis

What is vasculitis?

Vasculitis occurs when there is inflammation of your blood vessels.

The inflammation can cause blood vessels to narrow. This may reduce blood flow to part of the body (ischaemia) or cause blood clots (thrombosis).

Vasculitis can happen from a range of medical conditions (vasculitic disorders), most of which are quite rare.

Some common types of vasculitis include:

• giant cell (temporal) arteritis — affects arteries of the head and neck
• polymyalgia rheumatica — inflammation and swelling in joint and muscles
• Kawasaki disease — affects skin, mucous membranes, lymph nodes, and blood vessels
• polyarteritis nodosa — affects arteries, kidneys, gut, nerves, and skin

What causes vasculitis?

Vasculitis disorders can be from:

• autoimmunity, which means the immune system attacks the body’s own cells, tissues and organs
• allergy or hypersensitivity to medicines, toxins or irritants in the environment
• viruses or parasitic infections

Before considering autoimmunity as the cause of a vasculitis disorder, it’s important for your doctor to rule out causes that they can manage or treat, such as allergies, hypersensitivity, and infections.

What are the symptoms of vasculitis?

The symptoms of vasculitis can vary, depending on the specific type of the disorder.

General symptoms of vasculitis, include:

• fatigue
• fever
• muscle or joint pain
• poor appetite
• weight loss

Other symptoms can occur in different parts of your body, depending on the type of vasculitis:

• skin: rash, sores or purple or red spots, urticaria, itching
• lungs: shortness of breath, pneumonia, coughing up blood
• eyes: blurred vision, sensitivity to light, redness, itch and burning
• digestive tract: mouth ulcers, abdominal pain
• sinuses, nose, throat and ears: nasal congestion, blood nose, repeated ear infections, ulcers in the nose, hearing loss
• brain: headache, changes in mental function, muscle weakness, paralysis
• nerves: numbness, tingling, weakness, shooting pains

When should I see my doctor?

It is important to seek help right away if you think you have vasculitis, as early treatment can help prevent long-term damage. Once diagnosed you should see your doctor regularly to check how you are going as the disease can get better and worse over time.

How is vasculitis diagnosed?

It can be difficult to diagnose vasculitis because the symptoms can be similar to other illnesses.

Your doctor will ask you about your symptoms and examine you. Your doctor may also refer you for tests, including:

• blood and urine tests
• imaging scans including x-rays, CT scans or MRI scans
• angiography (which examines blood vessels)

In some cases, your doctor may also recommend lung function tests or nerve conduction studies.

To confirm a diagnosis of vasculitis, your doctor may also recommend a biopsy. This involves collecting a small sample of tissue for examination under a microscope.

How is vasculitis treated?

If the vasculitis is from an allergy or hypersensitivity, removing the cause usually stops the symptoms.

If it is due to an autoimmune condition, medicines can help control the symptoms and often leads to remission of the vasculitis (where symptoms become less severe or disappear).

Medicines for vasculitis include:

• corticosteroids to reduce inflammation
• medicines that suppress the immune system (for example cyclophosphamide, methotrexate or azathioprine)
• biologic agents, which act on certain parts of the immune system to control inflammation (for example rituximab, tocilizumab and mepolizumab)
• plasma exchange, intravenous gamma globulin or surgery, in very severe cases

You may need to take medicines for vasculitis for a long time, and they may have side effects, including your ability to fight infection. Talk to your doctor about influenza, pneumonia, and shingles vaccines to reduce your risk.

It is also important to talk to your doctor about how to reduce the side effects of your medicines.

To search medicines by active ingredient or brand name, use the healthdirect Medicines search feature.

Complications of vasculitis

If you have vasculitis that is not treated or took a long time to diagnose you may develop complications. The complications depend on the type of vasculitis you have and how severe it is.

Complications may include:

• heart problems
• organ damage
• aneurysm — bulging of a weak blood vessel which can burst and cause bleeding
• vision problems
• nerve problems resulting in numbness or weakness