Vasculitis is inflammation of the blood vessels thatresult in change on the walls of blood vessels.These changes in blood vessels can interfere with normal blood flow and cause disturbances in several organs of the body.
Blood vessels are channels that carry blood, along with the oxygen and nutrients in it, throughout the body. If the blood vessels become inflamed, the walls of the blood vessels can change.
Changes to the blood vessels can include:
- Thickening and narrowing, which makes it difficult for blood to flow to organs or body tissues
- Blockage, which can block blood flow, so that blood cannot flow at all to organs or body tissues
- Thinning and stretching, which can cause an aneurysm (bulging of a blood vessel), and heavy bleeding when the aneurysm ruptures
Vasculitis, also known as angiitis or arteritis, is of several types. There are types of vasculitis that only affect certain organs, such as the brain, eyes, or skin. However, there are also types of vasculitis that attack multiple organs at once.
Types of Vasculitis
Vasculitis can be grouped into three types based on the size of the affected blood vessels, namely:
- Large blood vessels, for example in rheumatic polymyalgia, Takayasu's arteritis, and giant cell arteritis
- Moderate vessels, eg in Buerger's disease, hypersensitive vasculitis, Kawasaki disease, and polyarteritis nodosa
- Small blood vessels, for example in Behcet's disease, Churg-Strauss syndrome, Henoch-Schonlein purpura, microscopic polyangiitis, Wegener's granulomatosis, cryoglobulinemia
Causes of Vasculitis
Vasculitis occurs when the body's immune system attacks its own blood vessels. It is not known exactly why this happened. However, disorders of the immune system are thought to be triggered by the following conditions:
- Autoimmune diseases, such as rheumatoid arthritis, lupus, or scleroderma
- Allergic reactions to certain medications
- Reactions to infections, such as hepatitis B and hepatitis C
- Blood cancers, such as lymphoma
vasculitis risk factors
Vasculitis can happen to anyone. However, the following factors can increase a person's risk of developing vasculitis:
- Have a family history of vasculitis
- Have a smoking habit, especially in Buerger's disease
- Using narcotics and dangerous drugs, such as cocaine
- Taking certain drugs, such as hydralazine, allopurinol, minocycline, and propylthiouracil
- Have an infectious disease, such as hepatitis B or hepatitis C
- Suffering from disorders of the immune system, such as suffering from lupus, rheumatoid arthritis, or scleroderma
Symptoms of Vasculitis
Symptoms of vasculitis vary widely and are generally associated with reduced blood flow to the body. Symptoms of vasculitis that can be felt by sufferers include:
- aches
- Fatigue
- Loss of appetite
- Weight loss
- Headache
- Sweating at night
- Rash on the skin
- Swelling
- Fever
- Numbness or numbness
In addition to the above complaints, there are also symptoms that specifically depend on the type of vasculitis experienced by the patient, such as:
- Takayasu's arteritis, with symptoms of numbness or chills in the body, impaired memory, and impaired vision
- Cryoglobulinemia, characterized by complaints of red or purple skin rashes on the lower limbs when in cold temperatures
- Giant cell arteritis, with symptoms of scalp pain, jaw pain when chewing, double vision, and temporary blindness
- Wegener's granulomatosis, with symptoms of shortness of breath, runny nose, wheezing, long-term sinusitis, ear infections, and facial pain
- Henoch-Schonlein purpura, which is characterized by abdominal pain, blood in the urine, joint pain, and a purple rash on the arms or lower legs
- Buerger's disease, which is characterized by numbness, tingling, or pain in the hands and feet, to gangrene (tissue death)
- Kawasaki disease, which is characterized by redness of the eyes and mouth, swollen glands in the neck, dry and cracked lips, or chest pain
- Microscopic polyangiitis, with symptoms such as coughing up blood, shortness of breath, and sometimes progressing to kidney failure
- Polyarteritis nodosa, with symptoms in the form of muscle and joint pain, abdominal pain after eating, numbness and tingling, anemia, and bleeding in the intestines
- Rheumatic polymyalgia, with symptoms of pain and stiffness in the shoulders, neck, and waist, especially after waking up
- Behcet's disease, with complaints of canker sores or sores in the oral cavity, sores in the genital area, acne-like skin lesions, inflammation of the eyes, pain and swelling in the joints, abdominal pain, and diarrhea
- Churg-Strauss syndrome, which is characterized by asthma, allergic rhinitis, and elevated white blood cell levels
- Hypersensitivity vasculitis, characterized by red spots on the skin, which usually appear on the lower legs or lower back
When to go to the doctor
Check with your doctor if you experience any of the symptoms mentioned above, especially if you are at risk of developing vasculitis.
Some types of vasculitis have symptoms that can worsen rapidly. Therefore, prompt diagnosis will increase the effectiveness of treatment for people with vasculitis.
Vasculitis Diagnosis
To diagnose vasculitis, the doctor will ask questions about the symptoms, lifestyle, medications taken, and the patient and family history of the disease. Next, the doctor will perform a physical examination to look for signs of vasculitis.
If the patient is suspected of having vasculitis, the doctor will perform further tests, such as:
- Biopsy, to check for tissue damage to the blood vessels or organs suspected of being affected by this condition, by taking tissue samples from the affected blood vessels or organs
- Blood tests, to detect antibodies that can attack blood vessels, and measure levels of inflammation markers in the body
- Scans, such as ultrasound, CT scan, PET scan, and MRI, to find blood vessels or organs affected by vasculitis
- Angiography, to see if the walls of the blood vessels are narrowed or dilated
Other specific tests may also be done, such as a urine test to detect kidney damage, or an electrocardiogram to check for heart damage.
Vasculitis Treatment
The method of treatment of vasculitis depends on the type of vasculitis, the organ affected, the underlying cause, and its severity. The goal of treatment is to relieve symptoms and prevent complications. Some of the treatment methods that can be done are:
Drugs
To reduce inflammation, doctors can give corticosteroid drugs, such as: prednisone or methylprednisolone.
Please note, long-term use of corticosteroids can cause side effects, such as diabetes and osteoporosis. Therefore, patients taking this drug should have regular check-ups with their doctor.
In addition to corticosteroids, doctors can also give immunosuppressant drugs, such as: cyclophosphamide or azathioprine, to suppress the immune system response by triggering damage to blood vessels.
In patients who cannot take immunosuppressants or suffer from Churg-Strauss syndrome vasculitis, doctors can provide biologic therapy with rituximab.
Operation
In some cases, vasculitis can cause an aneurysm or bulging of blood vessels. Vasculitis can also make arteries narrow, thereby blocking blood flow.
To overcome the above conditions, the doctor will perform surgery to prevent the rupture of blood vessels due to an aneurysm, and to expedite the blocked blood flow.
Vasculitis Complications
Complications from vasculitis depend on the type of vasculitis and the severity of the patient. In addition, complications can also occur due to side effects of drugs for vasculitis. Some complications that can be experienced by patients with vasculitis are:
- Blood clotting
- Aneurysm or aortic dissection
- Infections, such as pneumonia and sepsis, as a side effect of vasculitis treatment
- Damage to organs, such as the kidneys or heart
- Blindness, result giant cell arteritis which is not handled
- Pregnancy complications, such as preeclampsia, miscarriage, or slow growth of the fetus
- stroke
Vasculitis Prevention
The cause of vasculitis is not known with certainty so it is difficult to prevent. However, for those of you who have been diagnosed with vasculitis, do regular check-ups with your doctor, and undergo the treatment that has been given by the doctor. That way, your condition is always monitored and complications can be prevented.
Patients will also be advised to change their lifestyle to be healthier, by doing the following:
- Maintain ideal body weight
- Eat a balanced nutritious diet, such as vegetables and fruits
- Exercise regularly
- Manage stress well
- Quit smoking