Vasculitis

Vasculitis is a group of rare diseases caused by inflammation in the blood vessels. Rheumatologists at Atrium Health Floyd and Harbin Clinic often manage care for people with vasculitis. They work closely with other specialists to treat vasculitis-related problems in specific areas of your body.

What is vasculitis?

Vasculitis is a broad term that describes inflammation of the blood vessels. It can affect:

• Arteries: Blood vessels that carry oxygen- and nutrient-rich blood away from your heart
• Veins: Blood vessels that carry blood back to your heart
• Capillaries: The smallest blood vessels in your body that exchange nutrients, oxygen and waste products with your cells

Inflammation causes the blood vessels to become narrow. Restricted blood flow can damage tissues and organs, leading to serious complications.

Vasculitis types

There are many types of vasculitis, each with unique features. Some examples include:

• Behcet’s disease: This disease affects blood vessels in different parts of the body, including the brain, eyes, mouth, skin and genitals.
• Eosinophilic granulomatosis with polyangiitis (EGPA): Also called Churg-Strauss syndrome, this disease affects the lungs, skin, heart, kidneys, gastrointestinal tract and nervous system.
• Giant cell arteritis: This disease affects the aorta (the largest artery in your body), arteries that branch off the aorta, and arteries in the temples and scalp.
• Kawasaki disease: This childhood disease affects blood vessels throughout the body.

Causes of vasculitis

Doctors classify vasculitis as an autoimmune disorder. Autoimmune means your immune system attacks your own body. In this case, the target is your blood vessels, which leads to inflammation. Why this happens isn’t clear, although it likely involves a combination of factors, such as:

• Allergic reactions
• Environmental factors
• Genetics
• Infections
• Medications
• Other diseases

Vasculitis symptoms

General symptoms of vasculitis include:

• Aches and pains
• Fatigue
• Fever
• Weight loss

Other symptoms depend on which organs, structures and tissues are affected:

• Brain: You may have headaches, difficulty thinking or stroke-like symptoms.
• Ears and nose: You may experience sinus or ear infections, runny nose, dizziness, ringing in the ears or hearing loss.
• Eyes: You may develop red, itchy eyes, blurred vision or blindness.
• Gastrointestinal tract: You may get sores in your mouth or experience vomiting, diarrhea or stomach pain.
• Joints: Your joints may ache or develop arthritis.
• Lungs: You may feel short of breath or cough up blood.
• Nerves: You may feel numbness, tingling, weakness or pain in the affected areas.
• Skin: You may notice skin changes, such as spots, bumps, splotches, bruises or hives.

Vasculitis complications

Blood vessel inflammation can block blood flow, potentially causing serious problems with the heart, arteries, veins and kidneys:

• Heart, arteries and veins: You may experience coronary heart disease, high or low blood pressure, arrhythmia, aneurysm, aortic dissection, heart attack or deep vein thrombosis.
• Kidneys: You may develop kidney disease.

Vasculitis diagnosis

Diagnosing vasculitis can be challenging. You may need to see more than one specialist if the condition involves multiple areas of your body.

Diagnosis usually starts with a review of your symptoms and medical history and a physical exam. Your doctor may order blood tests to look for markers of inflammation. A biopsy, which is a procedure to collect a tissue sample for laboratory analysis, can also help confirm a diagnosis.

Based on your symptoms, your doctor may order medical imaging or other specific tests.

Vasculitis risk factors

Risk factors vary for the different types of vasculitis. Some types run in families or affect people of a certain age, sex or ethnicity. Others are linked to medications, smoking or illegal drugs.

Sometimes, an autoimmune disorder, such as lupus, rheumatoid arthritis or scleroderma, triggers vasculitis. You can have these disorders for years before developing vasculitis. Other conditions that may increase your risk include hepatitis B or C, lymphoma and COVID-19.

Vasculitis prevention

You usually can’t prevent vasculitis, but treatment may help prevent or delay complications.

Vasculitis treatment

Medicines to control inflammation and achieve remission (a period of low disease activity) are the main treatment for vasculitis. Your doctor may recommend other treatments based on the type of vasculitis, organs affected and severity of the condition.