What is vasculitis?

Vasculitis is an inflammation of blood vessels, including arteries and veins. It is also known as angiitis and arteritis.

The inflammation can cause your blood vessels to narrow. This may restrict blood flow to part of your body (ischaemia) or stop it altogether (thrombosis). Sometimes the vessel wall may weaken and balloon out (an aneurysm), which can cause bleeding.

Inflammation can also lead to tissue damage affecting one or many body organs such as the kidneys and lungs.

There are a number of types of vasculitis, including:

• polymyalgia rheumatica
• giant cell arteritis
• polyarteritis nodosa
• Wegener's granulomatosis
• Churg-Strauss syndrome
• Henoch-Schonlein purpura

What causes vasculitis?

In most cases, the cause of vasculitis is unknown. A combination of factors seems to kick off the inflammatory process.

There are 2 main categories of vasculitis: primary and secondary.

Primary vasculitis

This is due to an autoimmune reaction, where your own immune cells attack your body.

Secondary vasculitis

Where the autoimmune reaction is triggered by something, such as:

• a medicine or drug
• exposure to a toxin or pollutant
• an infection or another inflammatory disorder

Vasculitis symptoms

The symptoms of vasculitis can vary greatly and include:

• tiredness
• headache
• fever
• muscle or joint pain
• abdominal pain
• weight loss
• rash
• numbness or weakness in various parts of your body
• kidney problems

Different types of vasculitis cause different symptoms depending on which organs are affected. For example, your eyes, skin, lungs, gut, kidneys or nervous system may be affected.

It is important to seek help right away if you think you have vasculitis, as early treatment may help prevent long-term damage.

Vasculitis diagnosis

It can be difficult to diagnose vasculitis because the symptoms can be similar to those caused by some other illnesses.

Your doctor will ask you about your symptoms and examine you.

You may have laboratory tests done, such as blood tests and urine tests, and imaging tests such as an x-ray (including angiography — a special type of x-ray that looks at your blood vessels), CT (computerised tomography) scan, or MRI (magnetic resonance imaging) scan. In some cases, lung function tests or nerve conduction studies may also be done.

To confirm a diagnosis of vasculitis, a small sample of tissue (a biopsy) is often needed to examine under the microscope.

Vasculitis treatment

There is no cure for vasculitis, but treatment can help control your symptoms and often leads to remission of the vasculitis (where symptoms become less severe or disappear). Some people have chronic (long-term) vasculitis, however, and never go into remission.

Medicines for vasculitis work by:

• controlling the inflammation (for example, corticosteroids)
• suppressing the immune system (for example cyclophosphamide, methotrexate or azathioprine)

Newer medications called ‘biologics’ are increasingly being used to treat some forms of vasculitis.

Side effects of treatment

The medicines used to manage vasculitis often have to be taken for a long time and can have side effects. It is important to talk to your doctor about your medicines and their advantages and disadvantages. Eating well, exercising and stopping smoking if you smoke can help to minimise side effects.

Emotional support

Vasculitis is often a chronic disease and you may need emotional support from your family and friends to help you cope. Your doctor may also be able to provide you with information about support groups for people with vasculitis.

The Autoimmune Resource & Research Centre can provide support and information.