Vasculitis, which is also known as Angiitis & Arteritis is basically an inflammation of blood vessels. This is normally caused due to changes in walls inside blood vessels including narrowing, weakening, thickening & scarring issues. These changes subsequently restrict flow of blood & result in damage to tissues & organs. Although there are many varieties of vasculitis, good news is that most of these are rare. Quite often, vasculitis may just affect a single organ like skin, or it may involve several in other cases. Vasculitis conditions may either be acute (short term) or chronic (long lasting). Though some types of vasculitis are more common among certain groups of people, they can however affect anyone. Patients are often found to improve without any treatment, but which also depends upon the type of vasculitis. Certain cases of vasculitis however require medications in order to control inflammation & so as to prevent flare-ups.
Signs & Symptoms of Vasculitis
Signs & symptoms of vasculitis greatly vary & most often are related to decreased flow of blood throughout the body.
General signs & symptoms of vasculitis include the following.
- Weight Loss
- Night Sweats
- General Aches & Pains
- Loss of Pulse in Limbs
- Nerve Problems like Weakness or Numbness
Signs & Symptoms of Specific Types of Vasculitis
These are specifically related to other types of vasculitis. Symptoms can often develop early & rapidly or in some cases in later stages of this disease.
- Behcet’s Syndrome – This condition is most often caused by inflammation of veins & arteries. Moreover, it generally appears between 20 – 30 years of age. Common signs & symptoms of Behcet’s syndrome include eye inflammation, genital & mouth ulcers along with acne-like incisions on skin.
- Buerger’s Disease – This condition is caused by inflammation & by blood clots in blood vessels of hands & feet. It can eventually cause pain in feet, legs, hands & arms, & ulcers on toes & fingers. Moreover, this disease is linked to smoking cigarettes. This condition is also known as thromboangiitis obliterans.
- Cryoglobulinemia – This condition is found to result from abnormal proteins found in blood. Most often this is associated with hepatitis C infections. Cryoglobulinemia signs & symptoms include weakness, joint pain, rashes 7 tingling or numbness.
- Churg-Strauss Syndrome or Eosinophilic Granulomatosis with Polyangiitis – This is a very rare condition which mainly affects lungs, kidneys & nerves in limbs. Symptoms however greatly vary & include sinus changes, nerve pain & asthma.
- Giant Cell Arteritis – This condition is basically an inflammation of arteries in head, especially around the temples of patients. It is usually found to occur among people who are above 50 years of age. Signs & symptoms of giant cell arteritis include jaw pain, scalp tenderness, headaches, double or blurred vision which can even cause blindness. Giant cell arteritis is also known as Temporal Arteritis. It is linked to polymyalgia rheumatica which can also cause pain in muscles of thighs, hips, shoulders & neck.
- Wegener’s Granulomatosis or Granulomatosis with Polyangiitis – This causes inflammation of blood vessels in lungs, throat, sinuses, nose & kidneys. Signs & symptoms of this condition include nose bleeds, sinus infections & nasal stuffiness. Affected tissues generally develop lumps known as granulomas. In case lungs are affected patients may also cough up blood. Kidneys are also most often affected, but most people do not display any noticeable symptoms until damage is in advanced stages.
- Henoch-Schonlein Purpura – Inflammation of capillaries or small blood vessels of kidneys, bowels, joints & skin are expected in this condition. Signs & symptoms of Henoch-Schonlein Purpura include joint pain, blood in urine, abdominal pain & a rash on lower legs or buttocks. Moreover, this condition usually affects children but can also occur in people of any age.
- Hypersensitivity Vasculitis – Primary sign of this condition is appearance of a red spot on skin which is usually on lower legs. Hypersensitivity vasculitis can also be triggered by infection or as a result of an adverse reaction to certain medications.
- Kawasaki Disease – This condition is most often found to affect children who are younger than 5 years of age. Signs & symptoms of Kawasaki Disease include rash, eye inflammation & fever. This condition is also known as Mucocutaneous Lymph Node Syndrome.
- Microscopic Polyangiitis – This type of vasculitis usually affects small blood vessels like those in lungs & kidneys. Patients in this condition may develop a rash & pain in abdomen. In case lungs are affected, patients are also likely to cough up blood as well.
- Polyarteritis Nodosa – This type of vasculitis generally affects the nerves, digestive tract, kidneys & skin. Most often, this is associated with hepatitis B infections. Signs & symptoms of polyarteritis nodosa include a rash, high blood pressure, abdominal pain, muscle & joint pain, & kidney problems.
- Takayasy’s Arteritis – This condition of vasculitis affects large arteries within the body including the aorta. Typically occurring among young women, Takayasu’s Arteritis signs & symptoms include headaches, high blood pressure, loss of pulse, visual changes & feeling of coldness or numbness in limbs.
People should make an appointment with doctors in case they experience any worrying signs & symptoms. Some forms of vasculitis can quickly get worse therefore early diagnosis is an ideal option for patients to get effective treatment.
Causes for Developing Vasculitis
Exact causes of vasculitis are not yet fully understood. However, some forms of vasculitis are related to genetic makeup of patients while others generally result from immune system attacking blood vessel by mistake. Possible triggers for this reaction of immune system include the following.
- Blood cancers
- Infections like hepatitis B & hepatitis C
- Immune system diseases like scleroderma, lupus & rheumatoid arthritis
- Reactions to certain drugs & medications
Blood vessels which are affected by vasculitis may either bleed or become inflamed. Inflammation may subsequently cause layers of blood vessel walls to thicken & which in turn will narrow the passage of blood vessels. This will eventually result in reducing the amount of blood flow & therefore oxygen & vital nutrients which are necessary to reach body tissues & organs for proper functioning.
Preparing for Initial Appointment
People experiencing worrying signs or symptoms must fix an appointment with the concerned doctors. If the primary doctor suspects that the patient is having vasculitis, s/he may refer the patient to a rheumatologist who is specializing in joint & muscle problems. Vasculitis patients may effectively benefit from their experience in dealing with this condition. A multidisciplinary approach may also be helpful for people in this condition. The type of specialist which vasculitis patients should seek will depend upon the type & severity of their condition.
Specialists treating vasculitis problems include the following.
- Rheumatologists – joints & connective tissue doctors
- Neurologists – nervous system & brain doctors
- Ophthalmologists – eye doctors
- Cardiologists – heart doctors
- Nephrologists – kidney doctors
- Pulmonologists – lung doctors
- Dermatologists – skin doctors
- Urologists – urinary & urogenital doctors
- Doctors treating infectious diseases
Since appointments with specialist doctors can be brief & there is plenty of ground to cover in this short period of time, it would be a sensible idea that patients stay well prepared & include the following steps.
- Be Aware of Pre-Appointment Restrictions – Patients should check out if they need to do anything in advance of the initial appointment, like restricting their diet.
- List All Symptoms they are Experiencing – This list should include all symptoms including any which may seem unrelated to vasculitis for which this appointment is scheduled.
- List Personal Medical Information – This should include information about recent health problems and/or major stresses which the patient is having. The list should also include details of any medications they are consuming, including vitamins & supplements.
- Take Along a Family Member or Friend for Initial Appointment – Someone accompanying the patient will be able to help remember all that was discussed between the doctor & patient during the initial appointment.
- Make a List of Questions to Ask Doctors – This will help the patient find out all that he wants to know about the disease & treatment. Without this list he may forget some questions & be unable to recall during initial appointment with the specialist doctor.
Common List of Questions which Vasculitis Patients Can Ask Specialist Doctors
- Which type of vasculitis am I having?
- What is the cause of my vasculitis problem?
- Do I need to undergo more tests?
- Is my vasculitis problem acute or chronic?
- Will my vasculitis problem solve without any treatment?
- How serious is my vasculitis condition?
- Has vasculitis seriously damaged any part of my body?
- Is my vasculitis problem curable?
- What treatment options do I have for my vasculitis condition?
- Can you let me know the risks & benefits of treatments you are suggesting?
- Which one treatment do you feel is most suitable for my vasculitis condition?
- How long will my vasculitis treatment last?
- Apart from vasculitis, I am having another medical condition. So how best can I manage these conditions together?
- Do I need to see another specialist?
- Can you provide me brochures or some other printed material on my vasculitis condition?
- Which websites do you recommend I refer to?
Common Questions which Doctors Ask Vasculitis Patients
- When did you first begin to experience these vasculitis symptoms?
- Have these vasculitis symptoms been occasional or continuous?
- How severe are these vasculitis symptoms?
- What is it, if anything, that seems to improve vasculitis symptoms?
- What is it, if anything, which appears to worsen vasculitis symptoms?
Tests & Diagnosis for Vasculitis
Doctors are most likely to start by taking the patient’s medical history & performing a physical examination. They may also ask patients to undergo one or more of the following diagnostic tests & procedures.
- Blood Tests – These tests allow looking for signs of inflammation like that of high levels of C-reactive protein. Complete blood cell count will tell whether patients are having enough quantity of red blood cells in circulation. Blood tests which look for certain antibodies like the anti-neutrophil Cytoplasmic antibodies test may also be helpful in diagnosing vasculitis.
- Urine Tests – These tests can effectively reveal whether patient’s urine is containing red blood cells or is having too much protein that signals a medical problem like vasculitis.
- Imaging Tests – These are noninvasive imaging techniques which help determine which blood vessels & organs are affected by vasculitis. These imaging tests also help doctors monitor whether patients are positively responding to treatment. Normal imaging tests for vasculitis include PET – positron emission tomography, MRI – magnetic resonance imaging, CT – computerized tomography, ultrasound & X-rays.
- Angiography – X-Rays of Blood Vessels – A flexible catheter resembling a thin straw is inserted into a large vein or artery during this procedure. A special dye is then injected as contrast medium into catheter after which X-rays are taken as the dye fills these veins or arteries. Outlines of blood vessels come visible on X-rays as a result.
- Biopsy – This is basically a surgical procedure which involves removal of a small sample of tissue by surgeons from affected area of the patient’s body. Doctors will subsequently examine this tissue for any signs of vasculitis problems.
Treatment & Drugs for Vasculitis
Treatment for vasculitis will generally be focused on controlling inflammation with help of medications & resolving the underlying disease which triggered the problem. Patients may go through two treatment phases for vasculitis; Starting with stopping inflammation & subsequently preventing relapse which is known as maintenance therapy. Both these phases involve prescription of drugs. Which drugs to administer & the duration for which patients will need them will depend upon the type of vasculitis including the involvement of specific organs & the seriousness of the condition. Many cases of vasculitis report initial success with treatment & then subsequently experience flare-ups, while many others never experience vasculitis to completely go away & therefore will require ongoing treatment.
Medications Useful in Treating Vasculitis
- Corticosteroids to Control Inflammation – Doctors may prescribe corticosteroid drugs like methylprednisolone (Medrol) or prednisone. These drugs can help control inflammation in affected blood vessels. Corticosteroids side effects can be severe, especially when they are taken for long periods of time. Possible side effects of these drugs include osteoporosis (bone thinning), diabetes & weight gain. In case corticosteroids are needed for long-term as maintenance therapy, they should be prescribed in the lowest dose possible.
- Medications to Affect Immune System – Doctors may prescribe cytotoxic or immunosuppressant drugs when patients do not positively respond to corticosteroids. These drugs can effectively kill or decrease function of immune system cells which are causing inflammation. Main drugs in this category include cyclophosphamide, methotrexate (Rheumatrex, Trexall) & azathioprine (Imuran, Azasan). Possible side effects of cyclophosphamide include increased risk of infection, infertility & cancer. This is the reason why even though the drug is effective in controlling inflammation, cyclophosphamide is not always the first choice for treatment, especially when it is given as long-term therapy. Rituximab is a safe & effective option for treating many types of vasculitis. Rituximab (Rituxan) has also proved to be useful in maintenance therapy, unless the patient is having hepatitis B. Increased risk of reactivating hepatitis B is a side effect of rituximab.
Risks & Complications of Vasculitis
Complications resulting from vasculitis normally depend upon the type & severity of the condition. Sometimes they are also related to side effects of medications that were prescribed as treatment. Complications of vasculitis include some of the following.
- Organ Damage – Some types of vasculitis which can be severe may cause damage to major organs in the body.
- Aneurysms & Blood Clots – Blood clots which can form in blood vessels may result in obstructing blood flow. Although rare, vasculitis may cause blood vessel to weaken & bulge so as to form an aneyrysm. Patients will in such a scenario need surgery so as to remove the aneurysm.
- Infections – These include severe & life-threatening conditions like pneumonia & sepsis (blood infection).
- Blindness or Loss of Vision – This is a possibility resulting as a complication when giant cell arteritis is left without proper treatment.
Coping & Support for Vasculitis Patients
Coping with side effects of medication may be one of the greatest challenges of living with vasculitis condition. Vasculitis patients can consider the following suggestions which may prove to be extremely helpful.
- Understanding this Medical Condition – Patients must learn everything they can about vasculitis including treatments. Knowing possible side effects of the drugs they are taking & conveying to doctors about changes in health will prove beneficial.
- Follow the Treatment Plan – Vasculitis treatment plan will include visiting the doctor regularly & undergoing further test when needed & keeping tab on the blood pressure.
- Choose Healthy Diet – Keeping up with a healthy diet can prevent potential problems which can result from medications given as treatment for vasculitis. These include diabetes, high blood pressure & thinning of bones. Therefore patients must choose a diet which emphasizes on vegetables & fresh fruits, low-fat dairy products, whole grains, fish & lean meats. In case patients are on corticosteroid drugs they should check with the doctor if they also need to take vitamin D or calcium supplement.
- Get Routine Vaccinations – Updating on vaccinations like for pneumonia & flu will help prevent problems arising from infections which can result as side effects of vasculitis medications given for treatment.
- Exercise Regularly – Walking & regular aerobic exercises can help prevent diabetes, high blood pressure & bone loss which are normally associated with taking corticosteroid drugs. This can also benefit the lungs & heart of patients. Additionally, several people find that these exercises are effective in improving mood & overall sense of well being. Patients who are not used to exercising may start out slowly & gradually build up momentum. Doctors can also help patients plan an exercise regimen which is right for them.
- Maintain a Durable Support System – Maintaining a strong system for support which includes family & friends will help patients cope with this condition. Patients can also talk to them & with other people who are living with vasculitis problem. Healthcare team associated with the doctor can help connect vasculitis patients with such support groups.
Affordable Treatments for Vasculitis in India
India has emerged as a leading medical tourism destination over the past decade. With cost of healthcare rising in the western world beyond the reach of common man, people are seeking good quality but low cost medical procedure beyond borders to fit their budgets. India has a well established healthcare infrastructure managed by competent medical professionals. This has attracted people from all around the world to come to India so as to overcome their medical problems. IndianMedTrip is one of the most reputed global medical tourism companies based in South Asia providing a wide spectrum of affordable healthcare services including vascular surgery & treatment for vasculitis to international patients. Moreover, consultants at IndianMedTrip would also be delighted to combine an exotic recuperative holiday to go along with your healthcare treatment so as to make your journey a memorable experience.