Vasculitis: Treatment for Autoimmune Symptoms

Vasculitis is a medical condition involving swollen or inflamed blood vessels that can affect different parts of the body. It can be caused by viruses such as hepatitis B or C, other infections, side effects of medications, cancer, or autoimmune diseases such as systemic lupus erythematosus (SLE). When the blood vessels become inflamed, it inhibits blood flow and can lead to complications, including organ damage.

Learn about vasculitis, its causes and risk factors, types, treatment options, and more.

Autoimmune Effects of Vasculitis

An autoimmune reaction happens when the immune system attacks healthy cells in the body. This can lead to inflammation in various organs and regions of the body, sometimes in the entire body. When the blood vessels that carry blood throughout the body—including arteries, veins, and capillaries—become inflamed, it can prevent blood flow. Since blood flow is required for the body to function properly, this can lead to various complications.

Causes and Risk Factors

Vasculitis can have many different causes, and sometimes the cause is not known.

Some possibilities include:

• Autoimmune diseases, including rheumatoid arthritis
• Cancer
• Cocaine use and other illegal drugs
• Genetics
• Infections
• Medications, including hydralazine and propylthiouracil
• Smoking

Some people are more likely to experience vasculitis than others, and risk factors vary for the different types of vasculitis. Some types of vasculitis are more common among women, while other types are more common among men.

Similarly, some types are more likely to happen later in life, while others, such as Kawasaki disease and IgA (immunoglobulin A) vasculitis, are more likely to affect children. Healthy lifestyle choices can help to prevent vasculitis from happening.

Symptoms: How Do You Know You Have Vasculitis?

The symptoms of vasculitis vary depending on the type and the part of the body affected. There can be a rash, which may look like hives, or a spotty red or purple rash that most commonly affects the legs and lower regions of the body, but can also show up on the upper areas of the body.

Other symptoms of vasculitis may include:

• Breathing challenges
• Blood pressure changes
• Fatigue
• Fever
• Headaches
• Increased heart rate
• Joint pain
• Unintended weight loss
• Vision loss

Consult a healthcare provider about these or other symptoms. The effects of vasculitis can be severe and life-threatening.

Vasculitis Classification and Types

There are three primary classifications of vasculitis—large, medium, and small vessel vasculitis—based on the size of the blood vessels they affect. Other types of vasculitis, including Behcet's syndrome and relapsing polychondritis, can affect various sizes of blood vessels.

Large Vessel Vasculitis

Large vessel vasculitis includes:

• Giant cell arteritis (GCA) may affect the eyes, joints, and aorta. It typically occurs in adults over 50 and can cause headaches, jaw pain, flu-like symptoms, fatigue, and fever. GCA can also lead to eye problems and vision loss.
• Takayasu's arteritis affects large and medium arteries and artery branches, with widespread inflammation and damage. It is more common among young women and involves symptoms such as loss of appetite, weight loss, fever, and a general unwell feeling.
• Aortitis affects the primary blood vessel to the heart (aorta). It can have different causes, including systemic lupus erythematosus (SLE), so no specific category of people is most susceptible. Symptoms may include decreased appetite, fatigue, fever, headache, pain in the chest, and weight loss.
  

Medium Vessel Vasculitis

Medium vessel vasculitis includes:

• Kawasaki disease (KD) or Kawasaki syndrome involves inflammation of the blood vessels that carry blood to the heart. It is more common among young children, typically before age five, and can cause eye redness, fever, mouth irritation, and heart damage.
• Polyarteritis nodosa affects the blood vessels of various body areas, such as the digestive tract, heart, joints, nervous system, and skin. It is more common among men of middle age, and symptoms may include breathing challenges, fatigue, pain in the abdomen or joints, sores on the skin, weakness or loss of feeling in the hands or feet, or weight loss.
  

Small Vessel Vasculitis

Small vessel vasculitis includes:

• Granulomatosis with polyangiitis (GPA), or Wegener’s granulomatosis, involves inflammation of the blood vessels of areas of the body, such as kidneys, lungs, and sinuses. It is more common among men of middle age. It may lead to symptoms such as breathing challenges, cough, fatigue, fever, kidney issues, nasal congestion, painful joints, runny nose, or nosebleeds.
• Microscopic polyangiitis involves inflammation of the blood vessels and can affect the lungs, kidneys, nerves, and skin. It is more common among men of middle age, and symptoms may include blood in the urine, breathing challenges, a cough that can consist of blood, pain in joints or muscles, and rash on the skin.

Getting a Vasculitis Diagnosis

It can be challenging to get a vasculitis diagnosis, especially when the symptoms develop slowly, sometimes over years, which can happen with Takayasu's arteritis. The diagnostic process may differ depending on the type, but it generally includes a physical exam by a healthcare provider, a medical history and symptom evaluation, and testing. The testing may include blood tests, imaging such as x-rays or ultrasound, biopsy, and urinalysis.

Treatment to Manage Vasculitis

The treatment of vasculitis depends on the type, symptoms, severity, and part of the body affected. If you have vasculitis, a healthcare provider may prescribe medications to reduce inflammation and open the blood vessels, restoring blood flow.

These medications may include over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen) or Aleve (naproxen sodium), or prescription anti-inflammatory medications for more severe cases. If an underlying autoimmune condition causes your vasculitis, a provider may prescribe medications to suppress the immune system to stop the autoimmune response.

Sometimes, a combination of medications is used to minimize the side effects of more powerful drugs.

Long-Term Considerations

One of the most significant long-term considerations for vasculitis is its impact on the body, especially if left untreated. Vital organs can be damaged, sometimes severe enough to cause organ failure when they do not receive enough blood. With treatment, the outlook for vasculitis is good, with a high survival rate and improved quality of life as treatments can decrease symptoms.

Resources and Support

There are many resources available and options for support for anyone experiencing vasculitis. The Vasculitis Foundation is a great place to start with learning resources and opportunities to connect with support on their website, including virtual support meetings.

Additionally, there are more specific resources and support options for different types of vasculitis, with some local options available. If you or someone you know is experiencing vasculitis, talk to a healthcare provider about resources and support.

Summary

Vasculitis is a medical condition that involves restricted blood flow due to inflamed blood vessels. An autoimmune response causes some types of vasculitis. Other causes may include cancer, infections, and smoking. The symptoms vary, but people with this condition may experience a rash, fatigue, pain, and more.

There are different types, and reaching a diagnosis may be challenging or take time. Treatment can help to reduce the inflammation, open the blood vessels to restore blood flow, alleviate symptoms, and improve your quality of life.