When the body's immune system mistakenly attacks its own blood vessels, it leads to a condition known as vasculitis. This inflammation of the blood vessels can affect arteries, veins, and capillaries, reducing blood flow to vital organs and tissues. Vasculitis is not a single disease but a group of disorders that vary greatly in severity, affected organs, and treatment needs. Understanding the causes, recognising the symptoms, and knowing the available treatment options can help manage this complex condition effectively.

What Causes Vasculitis?

The exact cause of vasculitis is often unknown. However, several factors can trigger the immune system to attack blood vessels:

1. Autoimmune Disorders: Many forms of vasculitis are autoimmune in nature, meaning the body's defence system mistakenly identifies its own cells as foreign invaders. Conditions like rheumatoid arthritis, lupus, and Sjogren's syndrome are commonly associated with vasculitis.
2. Infections: Certain viral, bacterial, or fungal infections can provoke an immune response that leads to inflammation of blood vessels.
3. Medications: Some drugs can cause hypersensitivity reactions resulting in vasculitis. Antibiotics, blood pressure medications, and anti-seizure drugs are among those occasionally implicated.
4. Genetic Factors: In some cases, hereditary factors may make individuals more susceptible to developing vasculitis.
5. Environmental Triggers: Exposure to certain chemicals, toxins, or prolonged stress may also play a role in triggering the condition.

Types of Vasculitis

Vasculitis is classified based on the size of the blood vessels affected and the specific organs involved. Some of the most common types include:

• Giant Cell Arteritis (Temporal Arteritis): Typically affects the large arteries, particularly those in the head. It mostly occurs in older adults.
• Takayasu Arteritis: Affects large arteries, including the aorta and its branches, primarily in young women.
• Polyarteritis Nodosa: Involves medium-sized arteries and can affect organs like the kidneys, intestines, and nerves.
• Granulomatosis with Polyangiitis (Wegener's): Affects small to medium-sized vessels, often impacting the respiratory tract and kidneys.
• Microscopic Polyangiitis: Involves small vessels and frequently affects the kidneys, lungs, and nerves.
• Henoch-Schonlein Purpura: Typically affects small vessels in the skin, joints, intestines, and kidneys, and is more common in children.

Recognising the Symptoms of Vasculitis

Symptoms of vasculitis depend on the organs involved and the severity of the inflammation. Some general signs include:

• Fatigue: Persistent tiredness is a common symptom, regardless of the type of vasculitis.
• Fever: Low-grade fevers often accompany inflammation.
• Weight Loss: Unintentional weight loss can occur as the body struggles to cope with ongoing inflammation.
• Muscle and Joint Pain: Aches and stiffness are common.
• Skin Rashes: Purplish spots or red rashes, often seen in small vessel vasculitis.

When specific organs are involved, additional symptoms may develop:

• Nervous System: Numbness, tingling, or weakness.
• Kidneys: Blood in urine, high blood pressure.
• Lungs: Shortness of breath, coughing up blood.
• Digestive System: Abdominal pain, bloody stools.
• Eyes: Vision problems, pain, or redness.

Because these symptoms overlap with many other conditions, diagnosis often requires a careful evaluation by a healthcare professional.

Diagnosing Vasculitis

Diagnosis typically involves a combination of medical history, physical examination, and laboratory tests. Common diagnostic tools include:

• Blood Tests: To detect markers of inflammation such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
• Imaging Tests: MRI, CT scans, PET scans, or angiography may be used to view blood vessels and assess inflammation or blockages.
• Biopsy: Involves taking a small tissue sample from an affected organ or blood vessel to examine under a microscope.
• Urinalysis: To check for kidney involvement.

Early and accurate diagnosis is crucial to prevent complications and guide effective treatment.

Treatment Options for Vasculitis

The goal of treatment is to reduce inflammation and control the underlying immune response. Treatment plans often vary depending on the type and severity of vasculitis but may include:

1. Corticosteroids: These are often the first line of defence, helping to quickly reduce inflammation.
2. Immunosuppressive Medications: Drugs such as methotrexate, azathioprine, or cyclophosphamide may be used to control the immune system's activity.
3. Biologic Agents: Newer therapies like rituximab target specific components of the immune system and may be particularly useful in certain types of vasculitis.
4. Antiviral or Antibiotic Therapy: If an infection is identified as the cause, targeted antimicrobial treatment may be necessary.
5. Plasma Exchange (Plasmapheresis): In severe cases, this procedure may be used to remove harmful antibodies from the blood.
6. Supportive Care: This includes managing symptoms like high blood pressure, pain, or infections that may arise during treatment.

Living with Vasculitis

While vasculitis can be a serious condition, many people respond well to treatment and can lead active lives. Regular follow-up care, adherence to medications, and lifestyle modifications can help manage the disease effectively. Some helpful practices include:

• Following a balanced, nutritious diet.
• Engaging in appropriate physical activity as advised by healthcare providers.
• Avoiding infections by staying up to date with vaccinations.
• Monitoring for any new or worsening symptoms.
• Joining support groups or counselling to address emotional and psychological challenges.

Conclusion

Vasculitis is a complex group of disorders that can affect various parts of the body with diverse symptoms and outcomes. Early diagnosis and prompt, targeted treatment are essential for managing inflammation and preventing long-term damage. With advances in medical research, treatment options continue to improve, offering hope and better quality of life for those affected by vasculitis. If you suspect you may have symptoms of vasculitis, consult a healthcare provider for a thorough evaluation and appropriate management.