Vasculitis

Vasculitis and arteritis are terms used to describe blood vessel inflammation. Vasculitis describes the inflammation of blood vessels in general, while arteritis more specifically refers to the inflammation of arteries.

Some varieties of vasculitis cause systemic blood vessel inflammation where the inflammation affects multiple sites in the body. Other types of vasculitis and arteritis cause blood vessel inflammation only in specific organs.

Symptoms of Vasculitis and Arteritis

Vasculitis

Blood vessel inflammation can have several effects on the vessels. Vasculitis and arteritis can cause blood vessels to narrow severely or collapse entirely, cutting off blood circulation. In other cases, it weakens blood vessels, allowing them to stretch to abnormal sizes.

As vasculitis and arteritis can affect almost any part of the body, symptoms of blood vessel inflammation are broad, and vary widely from one type of vasculitis to another. General symptoms include fever, low energy, unexplained weight loss and a loss of appetite. More specific symptoms depend on the location of the vasculitis or arteritis:

  • blood : anemia, high white blood cell count
  • brain: stroke, headaches, coordination problems
  • eyes: conjunctivitis, retinal disorders, blindness
  • gastrointestinal tract: abdominal pain, bloody diarrhea, intestinal perforations
  • heart: heart attack
  • joints: swelling, arthritis, achiness
  • kidneys: renal failure, blood in urine, protein in urine
  • lungs: cough (often with blood), difficulty breathing, lung cavities
  • nerves: loss of sensation, numbness, shooting pains, weakness
  • sinuses, ears, and nose: congestion, hearing loss, collapsed bridge of nose
  • skin: rashes, purple-red spots.

Causes of Vasculitis and Arteritis

Often the cause of blood vessel inflammation is unknown. Infections account for some cases of vasculitis and arteritis. Allergies to medication may sometimes trigger blood vessel inflammation.

Some evidence exists that vasculitis and arteritis are related to immune system disorders, which are a common cause of inflammation. Possible links have been suggested between blood vessel inflammation and immune disorders such as rheumatoid arthritis, systemic lupus erythematosus (SLE) and Sjörgen’s syndrome.

Treating Blood Vessel Inflammation

Whether vasculitis or arteritis, systemic or localized, almost all cases of blood vessel inflammation are treated with the same strategies. Corticosteroids, particularly prednisone, are used in varying doses to control inflammation. Low doses of chemotherapy medications are also employed to suppress the immune system.

Both chemotherapy and corticosteroids carry the risk of severe side effects, including a weakened immune system, blurred vision, and, in rare cases, blindness. When vasculitis requires long-term treatment (sometimes up to a year), medication side effects may hinder treatment.

Specific Vasculitis and Arteritis Conditions

Several specific types of vasculitis and arteritis have been identified.

Bechet’s Disease: Rare in the West, but a major cause of blindness in Japan, Bechet’s disease causes blood vessel inflammation in the eyes, lungs, mouth, skin, joints, genitals, brain and gastrointestinal tract.

Buerger’s Disease: Buerger’s disease affects heavy smokers, causing blood vessel inflammation in the hands and feet. Usual vasculitis or arteritis treatments are ineffective: Quitting smoking is the only cure.

Central Nervous System Vasculitis: This condition can causes seizure, memory disorders and confusion. It affects only the brain and the cure requires a year-long regimen of corticosteroids and chemotherapy.

Churg-Strauss Syndrome: A systemic arteritis, Chrug-Strauss syndrome affects the lungs, nasal cavities, heart and many other areas. Without treatment, this type of blood vessel inflammation causes serious nerve damage, heart attacks and lung bleeding.

Cryoglobulinemia: A type of systemic vasculitis associated with hepatitis C infections, cryoglobulinemia causes antibodies to coagulate under cold conditions. Treating hepatitis C sometimes provides relief of this condition.

Giant Cell Arteritis: The most common form of arteritis in adults, this variety of blood vessel inflammation has an average onset age of 72. People of Scandinavian descent are most at risk of giant cell arteritis.

Kawasaki Disease: An early childhood vasculitis of unknown origin, Kawasaki disease most frequently affects children under five. It generally resolves within a few weeks, but without treatment can result in heart disease.

Microscopic Polyangitis: A systemic variety of vasculitis, microscopic polyangitis can cause kidney infections, weight loss, skin lesions and nerve damage, especially in the hands and feet.

Polyarteritis Nodosa: More likely to affect men than women, this systemic blood vessel inflammation causes organ failure and is fatal unless treated.

Polymyalgia Rheumatica: This is a systemic blood vessel inflammation that tends to affect women of Northern European descent. Polymyalgia rheumatica is often found in combination with giant cell arteritis.

Rheumatoid Vasculitis: This is a systemic disease with a possible autoimmune origin. Rheumatoid vasculitis is often associated with rheumatoid arthritis.

Takayasu’s Arteritis: This is a chronic blood vessel inflammation of the aorta, the main artery in the body. Takayasu’s arteritis affects mostly Asian women, and is one of the rarest varieties of arteritis.

Wegener’s Granulomatosis: This is a systemic blood vessel inflammation in the lungs and kidneys. Relapses after treatment are common.

Resources

Cleveland Clinic Health Information Center. (2005). What you need to know about vasculitis.

John Hopkins Vasculitis Center. (nd). Types of vasculitis.

John Hopkins Vasculitis Center. (nd). What are the symptoms of vasculitis?

Mayo Foundation for Medical Education and Research. (2004). Polymyalgia rheumatica.

Mayo Foundation for Medical Education and Research. (nd). Treatment of cryoglobulinemia at mayo clinic.

National Library of Medicine. (updated 2003). Cryoglobulinemia. MedlinePlus Medical Encyclopedia.

Taubert, K.A.