Vasculitis Treatment

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Vasculitis Treatment

What is vasculitis?

Vasculitis is a rare autoimmune disorder that causes inflammation of the blood vessels which results in narrowing of the vessel’s canal. The narrowing is related to the vessel wall thickening. The thickened blood vessel reduces blood flow to that part of the body. The narrowing of blood vessels has the potential of causing serious complications as tissues, and vital organs may become damaged.

Who can develop vasculitis?

Any sex, race, or age group can develop vasculitis.

Where does vasculitis occur?

Vasculitis can occur in any blood vessel. This may involve any arteries, veins, or capillaries found in the body. Vasculitis can affect one organ or many simultaneously.

What are the different types of vasculitis?

There are several categories used to describe the different types of vasculitis. They are usually categorized based on the size of the blood vessel that the condition affects.

  • Large vessel
  • Medium vessel
  • Small vessel

Causes

What is the cause of vasculitis?

Vasculitis is believed to be related to the body attacking the blood vessels causing inflammation to the area. However, the exact mechanism of action of this occurring is not fully understood. It can occur alone or in conjunction with other autoimmune disorders such as lupus, rheumatoid arthritis, lupus or Sjorgen’s syndrome.

What are the risk factors for vasculitis?

There are some risk factors associated with the development of vasculitis:

  • Environmental factors - Triggers such as viruses, bacteria, fungi, or medications have been linked to vasculitis.
  • Autoimmune diseases - People with rheumatoid arthritis, lupus, and Sjogren’s syndrome have been linked to vasculitis as well.
  • Cancer - Cancers like leukemia or lymphoma have been known to be associated with the development of vasculitis.
  • Drug use -  There is a correlation of certain types of vasculitis conditions with the use of cocaine or tobacco abuse.
  • Genetics - Few conditions are linked to family members also having an increased risk of developing. Examples include Behcet's disease, granulomatosis with polyangiitis, and Kawasaki disease.

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Symptoms

What are the symptoms of vasculitis?

How vasculitis may present can vary from person to person. Symptoms are dependent on the type of vasculitis one possesses as well as what organ is involved. The symptoms may be short-lived or can linger and be a long-term problem. The most common symptoms include: 

  • Fatigue
  • Weight loss
  • Loss of appetite
  • Fever
  • Aches and pain
  • Rash
  • Joint pain
  • Shortness of breath
  • Gastrointestinal pain
  • Gastrointestinal ulcers
  • Ear infections
  • Hearing loss
  • Blurred vision
  • Burning eyes
  • Red eyes
  • Blindness (temporary or permanent) 
  • Headaches
  • Muscle weakness
  • Peripheral neuropathy

What complications are associated with vasculitis?

Complications associated with severe vasculitis include:

  • Vascular disease - Due to the obstruction of blood flow, problems with blood clots and other vascular conditions may occur.
  • Organ damage - Major organ damage may occur due to thickening. Long-term health complications can be a result of this occurring.
  • Vision complications - Vision loss may occur, which can be as severe as permanent blindness.

Diagnosis

How is vasculitis diagnosed?

As with most health conditions, vasculitis is diagnosed by a licensed healthcare provider after performing a comprehensive medical history and physical exam. This is vital as vasculitis may mimic many different medical conditions. Several blood tests and imaging such as x-rays and CT scans may also be ordered to help with the diagnosis.

Are there any diagnostic tests that can be performed to confirm vasculitis?

There are a variety of tests that can be used to help with diagnosis, but not one test can confirm vasculitis. Currently, the most definitive way to confirm the diagnosis of vasculitis is through biopsy of the skin, affected blood vessel, organ, or nerve.

Treatment

What are treatment options for vasculitis?

The goal for treatment in vasculitis is to reduce inflammation of the blood vessels or organs affected to prevent permanent damage.

Some non-surgical options for the management of vasculitis include: 

  • Corticosteroids - this is usually the most commonly used medication for vasculitis, however, if long-term use is needed, there are some complications that your healthcare provider will be monitoring for. Prednisone is usually a popular option for this type of medication.
  • Disease-modifying antirheumatic drugs (DMARDs) - dependent on the type of vasculitis treated or the severity of the condition. Examples include:
    • methotrexate (Trexall)
    • azathioprine (Imuran)
  • Immunosuppressants - these medications are usually used in conjunction with corticosteroids. Options include:
    • mycophenolate (CellCept)
    • cyclophosphamide
  • Biologic response modifiers (biologic agents) -  examples used for vasculitis include:
    • rituximab (Rituxan)
    • tocilizumab (Actemra)

Surgical options include:

  • Surgery - this may be required when an aneurysm occurs due to vasculitis or restriction of blood flow occurs that is life-threatening.

If you or someone you know is fighting this rare condition, there are healthcare providers at TeleMed2U that are familiar with this condition and effective treatment options that may be available to you. The first step in overcoming vasculitis is to become informed and learn what your options may be. Getting more information and the care you need is only one phone call away.

References

Hasan, U. (2017, March). Vasculitis.  American College of Rheumatology. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Vasculitis 
Mayo Clinic. (2020, November). Vasculitis. https://www.mayoclinic.org/diseases-conditions/vasculitis/symptoms-causes/syc-20363435#:~:text=Overview,in%20organ%20and%20tissue%20damage. 
Arthritis Foundation. (n.d.). Vasculitis.https://www.arthritis.org/diseases/vasculitis

Information

Medically reviewed by:

Dr Roy Kedem, MD

Dr Roy Kedem started his premedical studies at Harvard, and research in genetics and gene sequencing at Harvard, Beth Israel. He attended medical school in the UK at the Cambridge Overseas Medical Program in 1998.  Dr Kedem then completed his residency in Internal Medicine at Columbia College of Physicians and Surgeons in Stamford, Connecticut and his fellowship in Hospital Medicine at the Cleveland Clinic in Cleveland, Ohio.

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With Insurance

Rheumatology

Your copay
Depending on insurance

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Without Insurance

Rheumatology

$149

Initial Visit

$99

Follow Up
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