Vasculitis refers to a group of rare autoimmune diseases that cause inflammation in blood vessels—affecting arteries, veins, and capillaries. This inflammation may lead to narrowed, blocked, or weakened vessels, reducing or cutting off blood flow to vital organs and tissues. Depending on the type and severity, vasculitis can range from mild and self-limiting to life-threatening.

Types

Vasculitis is classified based on the size and location of the affected blood vessels. Some common types include:

  • Giant cell arteritis – Affects large arteries in the head and neck, usually in adults over 50.
  • Takayasu arteritis – Targets the aorta and its branches, common in women aged 40–50.
  • Kawasaki disease – Primarily impacts children under 5, affecting arteries throughout the body.
  • Microscopic polyangiitis – Involves small and medium vessels in the kidneys, lungs, and nerves.
  • Polyarteritis nodosa – Affects medium-sized arteries supplying organs like the skin, GI tract, and heart.
  • Eosinophilic granulomatosis with polyangiitis (EGPA) – Affects small arteries, often linked with asthma.
  • Rheumatoid vasculitis – Occurs in people with rheumatoid arthritis, involving small to medium vessels.
  • Cryoglobulinemia – Linked to hepatitis C, causing inflammation and clots in small vessels.
  • Central nervous system vasculitis – Involves blood vessels in the brain and spinal cord.
  • IgA vasculitis – Often found in children, affecting the skin, GI tract, joints, and kidneys.

Each type presents differently, and accurate diagnosis is essential for proper treatment.

Symptoms

Symptoms of vasculitis can vary greatly depending on the type, severity, and which organs or systems are involved. They may come on suddenly or gradually and can either be chronic or occur in flares.

General Symptoms

These systemic symptoms often appear first and may be mistaken for viral infections:

  • Persistent fatigue or exhaustion
  • Low-grade or high fever
  • Loss of appetite and unintended weight loss
  • Muscle aches and generalized pain
  • Night sweats or chills

Skin-Related Symptoms

When small vessels in the skin are affected, symptoms may include:

  • Palpable purpura: Raised, purple spots, often on the legs
  • Livedo reticularis: Mottled, lace-like skin discoloration
  • Ulcers or open sores
  • Red nodules or hives
  • Easy bruising or skin sensitivity

Joint and Muscle Symptoms

Joint involvement is common and may resemble arthritis:

  • Pain, especially in hands, wrists, and knees
  • Swelling or warmth around joints
  • Morning stiffness
  • Muscle tenderness or weakness

Nerve Symptoms

Vasculitis affecting the nervous system can cause:

  • Numbness or tingling in the hands and feet
  • Burning pain (neuropathy)
  • Loss of coordination or muscle control
  • Sudden limb weakness

Lung and Breathing Symptoms

If blood vessels in the lungs are involved:

  • Shortness of breath
  • Persistent dry or wet cough
  • Chest tightness or pain
  • Coughing up blood (in severe cases)

Gastrointestinal Symptoms

When GI tract vessels are inflamed:

  • Abdominal pain or cramping
  • Nausea or vomiting
  • Blood in stool or diarrhea
  • Mouth ulcers

Eye and Ear Symptoms

Eyes are sensitive to inflammation:

  • Red, itchy, or burning eyes
  • Blurred or double vision
  • Sensitivity to light
  • Hearing loss or ear fullness if sinuses and ears are involved

Brain and Cognitive Symptoms

Vasculitis involving the central nervous system may cause:

  • Severe headaches
  • Difficulty concentrating
  • Confusion or disorientation
  • Stroke-like symptoms (e.g., slurred speech, paralysis)

Vasculitis symptoms can affect multiple systems at once and may mimic other conditions, which often makes early detection challenging but essential.

Causes

The exact cause of vasculitis remains unknown in many cases. However, it is believed to involve a complex interplay between genetic susceptibility, environmental exposures, immune system dysfunction, and sometimes an existing health condition.

Autoimmune Response

Vasculitis typically arises when the immune system mistakenly attacks the body’s own blood vessels. This may be a result of the immune system misidentifying blood vessel cells as threats, triggering an inflammatory response that leads to swelling, narrowing, or rupture of the vessels.

Underlying Diseases

Vasculitis often coexists with or is triggered by other autoimmune or inflammatory conditions, such as:

  • Rheumatoid arthritis
  • Systemic lupus erythematosus (SLE)
  • Scleroderma
  • Inflammatory bowel disease (IBD)

These underlying diseases can initiate immune activity that spreads to the blood vessels.

Infections

Certain viral and bacterial infections are known to initiate vasculitis or trigger relapses. These include:

  • Hepatitis B and C
  • HIV
  • COVID-19 (rare cases)
  • Tuberculosis

The immune system’s heightened activity to combat these infections may inadvertently target blood vessels.

Medications

Drug-induced vasculitis can occur due to hypersensitivity reactions. Some medications linked to vasculitis include:

  • Hydralazine (for high blood pressure)
  • Allopurinol (used for gout)
  • Penicillin and sulfa-based antibiotics
  • Anti-TNF agents used for autoimmune disease management

Genetic Predisposition

Individuals with a family history of autoimmune diseases may have a higher genetic risk of developing vasculitis, particularly in childhood-onset types such as Kawasaki disease or IgA vasculitis.

Environmental Factors

Exposure to certain environmental agents and lifestyle factors may contribute to disease onset or flare-ups:

  • Smoking or secondhand smoke
  • Chemical or toxin exposure (e.g., silica)
  • Stress and trauma
  • Cold temperatures (as seen in cryoglobulinemia)

Diagnosis

A combination of clinical evaluation and tests is typically needed to diagnose vasculitis.

Diagnostic Tools

  • Blood tests: Measure inflammation markers and immune responses
  • Biopsy: Examines tissue from an affected area to confirm inflammation
  • Imaging: CT scans, X-rays, or PET scans to assess organ and vessel condition
  • Angiography: Identifies blockages or abnormalities in blood flow
  • Urinalysis: Detects signs of kidney involvement
  • Echocardiography: Evaluates heart function

A multidisciplinary team may be involved in the diagnosis process.

Treatment

Treatment depends on the type and severity of vasculitis. The main goals are to control inflammation, prevent organ damage, and maintain remission.

Medications

  • Corticosteroids: Like prednisone, used to quickly reduce inflammation
  • Immunosuppressants: Methotrexate, azathioprine, or cyclophosphamide may be added to lower immune activity
  • Biologics: Targeted therapies like rituximab, tocilizumab, or mepolizumab for specific types
  • NSAIDs: Used in mild cases for pain and inflammation relief

Procedures

  • Plasmapheresis: Filters the blood to remove harmful antibodies
  • Angioplasty: Widens narrowed blood vessels
  • Bypass surgery: Creates alternative pathways for blood flow

Early intervention is key to limiting long-term damage.

Prevention

While vasculitis can’t always be prevented, certain steps help reduce the risk of flare-ups:

  • Follow your treatment plan strictly
  • Stay up to date on vaccines (e.g., flu, COVID-19)
  • Eat a balanced diet rich in antioxidants and anti-inflammatory foods
  • Get regular physical activity
  • Avoid tobacco and limit alcohol
  • Manage stress through relaxation techniques
  • Sleep at least 7–8 hours per night

Related Conditions

Several autoimmune or inflammatory conditions are commonly linked to vasculitis:

  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Scleroderma
  • Inflammatory bowel disease (IBD)

Additionally, untreated vasculitis can result in severe complications:

  • Heart disease
  • Kidney failure
  • Stroke
  • Nerve damage
  • Vision loss

Living Well

With proper treatment and lifestyle modifications, many people with vasculitis live active, fulfilling lives. Here are some tips:

  • Attend regular check-ups to monitor progress
  • Track symptoms and report changes promptly
  • Build a support system with family, friends, or a support group
  • Be patient and prioritize rest during flares
  • Adjust activities based on your energy levels

Mental health is just as important—counseling or therapy can be beneficial if dealing with chronic fatigue or anxiety.

Disclaimer: This content is for informational purposes only and does not substitute for professional medical advice, diagnosis, or treatment. Please consult a healthcare provider for guidance specific to your condition.