Vasculitis - Causes, Symptoms And Treatment Of Vasculitis

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Vasculitis: Causes, Symptoms and Treatment

What is vasculitis?

Vasculitis is a common name for a group of diseases characterized by inflammation and destruction of the walls of blood vessels. Usually, the disease affects several tissues or organs: the narrowing of the damaged vessels disrupts the blood supply to the organs and causes the death of the tissues supplied by them. The disease can occur in any organ.

If the patient does not receive treatment, the vasculitis will not stop progressing. This will damage various tissues and organs. A person can become disabled or even die.

Vasculitis is a systemic disease that affects connective tissue. Rheumatologists are involved in the treatment of pathology. If necessary, the patient is referred to an infectious disease specialist and a dermatologist.

Both men and women suffer from vasculitis equally. Most often, the disease is diagnosed in children and the elderly. Pathology is gaining momentum. The number of people with vasculitis is increasing every year. Scientists associate this with the uncontrolled and unreasonable intake of immunomodulatory drugs, as well as with the deterioration of the environmental situation in the world as a whole.

Content:

• Classification of vasculitis
• Vasculitis symptoms
• Vasculitis causes
• Vasculitis treatment
• Forecast

Classification of vasculitis

Vasculitis has a large number of subspecies and classifications, they differ in severity, localization and etiology. Some vasculitis affects only the skin without causing serious harm to other organs, while others can cause irreparable damage to vital organs and, without proper treatment, lead to death.

Depending on the causes of the occurrence, vasculitis is divided into two types: primary and secondary:

• Primary vasculitis occurs independently and is not accompanied by other diseases.
• Secondary vasculitis is a concomitant disease of other pathologies. A similar reaction can occur to tuberculosis, hepatitis, syphilis, etc. Sometimes vasculitis is the result of systemic damage to the body (lupus erythematosus, collagenosis, reactive arthritis). Oncopathology, parasitic invasions, sarcoidosis, and intoxication of the body can provoke vasculitis.
• Depending on the severity of the disease, vasculitis can be:
• Lightweight. The general well-being of a person is not disturbed. The only manifestation of the disease is a mild skin rash.
• Medium-weight. In this case, the patient has multiple rashes on the body, blood appears in the urine, the joints are very sore, and the appetite disappears. General health is disturbed.
• Heavy. If the disease has a severe course, then the rash will be profuse, the joints and internal organs undergo pathological changes. The patient is hospitalized with internal bleeding (pulmonary or intestinal). Renal failure is often diagnosed. The patient feels very bad.

Forms of vasculitis:

1. Capillary. In this form of the disease, inflammation of the small blood vessels is observed.
2. Arteriolitis. Arterioles are inflamed.
3. Arteritis. Immune cells attack arteries.
4. Phlebitis. In this case, the veins become inflamed.

Types of vasculitis, depending on the location of the pathological process:

• Systemic necrotizing vasculitis. Inflammation spreads to several parts of the body, including periarteritis nodosa, micropolyangiitis, Churg-Strauss syndrome, mixed vasculitis, Wegener's granulomatosis, giant cell arteritis, nonspecific aortoarteritis, hemorrhagic vasculitis, allergic skin vasculitis, Kawasaki syndrome, Behcet's disease.
• Vasculitis of individual organs. The process of inflammation involves the vessels that feed a specific organ. If the brain suffers, then the patient develops primary angiitis of the central nervous system. When the vessels supplying the skin suffer, the patient is diagnosed with cutaneous leukocyte-clastic angiitis, periarteritis nodosa. If the joints are affected, then they talk about hemorrhagic vasculitis. When the heart is damaged, the patient develops isolated aortitis.

Vasculitis symptoms

Depending on the localization of vasculitis and concomitant disease, its symptomatic picture also varies. When vasculitis affects the skin, a rash appears. In the event of nerve damage, a person's sensitivity is disturbed - from hypersensitivity to its complete loss. Disruption of the blood supply to the brain causes a heart attack (heart stroke). Renal failure may result from renal vasculitis. Common symptoms of vasculitis include lack of appetite, fatigue, weakness, fever, and pallor.

Nodular vasculitis is characterized by muscle pain, weight loss, abdominal pain, nausea and vomiting, and mental disorders. Wegener's granulomatosis affects the paranasal sinuses: in patients, purulent and bloody discharge comes out of the nose, the nasal mucosa becomes covered with sores; there may be a cough (sometimes with blood), shortness of breath, chest pain, and renal failure may develop. Giant cell arteritis presents with fever, weakness, weight loss, severe headaches, and swelling in the temple area. Symptoms of nonspecific aortoarteritis are pain and weakness in the arms and legs, blurred vision, fainting. Behcet's syndrome is accompanied by recurrent stomatitis, genital ulcers, and eye inflammation.

Vasculitis can lead to disability and death of a person if it has a severe course.

Rash

Rashes with vasculitis may vary, but there are signs that make it possible to suspect this particular pathology:

• The rash appears after an infectious disease.
• The rashes are characterized by symmetry.
• The first elements of the rash appear on the legs. The shins are affected first.
• The rash looks like bruising. The skin in these places swells, tissue necrosis may begin.
• The elements of the rash are varied. Over time, they do not change their size, shape and color.

A vasculitis rash can be as follows:

• Spotty rash. The spots can be pink and reddish. The rash is flat, the spots do not rise above the surface of the dermis. Such spots appear due to the fact that blood rushes to the vessels in order to stop the inflammatory reaction.
• Hemorrhagic purpura. Such a rash appears when the integrity of the vascular wall is damaged. The rash looks like crimson spots. Its borders are uneven, elements in diameter can reach 3-10 mm. After a while, the elements of the rash turn blue and then turn yellow. If you press on the rash, it won't go away.
• Hives. This rash appears due to an allergic reaction in the body. The patient complains of burning and itching in the affected area. The rash itself looks like reddish-pink blisters of irregular shape.
• Subcutaneous nodules. Such elements of the rash are accompanied by an uncontrolled proliferation of connective tissue. The nodules can rise significantly above the surface of the dermis, or they can be flat. The sizes of the nodules are 10-20 mm. If you press on the element of the rash, then the person will feel pain. Since these elements of the rash do not receive normal nutrition, they undergo necrosis. It starts from the central part of the nodule, gradually spreading to the surrounding dermis.
• Bubbles. The walls of blood vessels in vasculitis lose their normal density. This leads to the fact that in some areas of the collaterals, plasma begins to sweat through their wall. It builds up under the skin, causing blistering. They will be filled with transparent content. Sometimes blood cells appear through the vessels.
• Ulcers and erosion. Subcutaneous nodes disintegrate over time. In their place, erosion and ulcers are formed. If an infection gets into them, which happens very often, then these areas begin to rot.

Intoxication of the body

Disturbances in the circulatory system lead to the accumulation of a large amount of toxins in the body. This becomes the reason for the failure of metabolic processes.

As a result, a person suffers from symptoms such as:

• Weakness and rapid physical fatigue.
• Lack of desire to eat, weight loss. A person can lose up to 1 kg per month.
• Increased sleepiness.
• Increased body temperature. If the disease is mild, then the mark on the thermometer does not exceed subfebrile indicators. In severe vasculitis, it reaches febrile values.

Neurological symptoms

Circulatory disorders affect the functioning of the nervous system.

This leads to the following symptoms:

• Emotional instability.
• Convulsive seizures.
• Muscle atony, partial paralysis of the limbs.
• Intracerebral hemorrhage, which can lead to hemorrhagic stroke.

Damage to the organs of vision

Vasculitis can affect both one and two eyes. The disease leads to visual impairment, up to the development of blindness. The mucous membrane of the eye turns red and swells. Eyeball movements provoke painful sensations. Development of exophthalmos is possible.

Respiratory system damage

Vascular problems lead to inflammation of the respiratory system.

This can be manifested by symptoms such as:

• Prolonged rhinitis.
• Long-term sinusitis and sinusitis.
• Destruction of the bony walls of the maxillary sinuses and the nasal septum.
• Bronchitis that lasts a long time and is difficult to treat.
• Bronchial asthma.
• Inflammation of the pleura of the lungs.
• Pneumonia.
• Bronchiectasis.

If there is a violation of the integrity of the vessels, then the patient develops bleeding. Their strength may vary.

Kidney damage

Vasculitis can lead to various kidney pathologies. In this case, a person complains of lower back pain, edema pursues him, the amount of urine excreted decreases. An increase in body temperature and the appearance of blood in the urine are possible.

The stronger the malnutrition of the kidneys, the more massive the damage to their tissues. Ultimately, the disease leads to the development of kidney failure.

Read more: Acute renal failure: symptoms and treatment

Diseases of the joints

Vasculitis can damage the bursa. Pathological exudate begins to accumulate in it, edema and inflammation develop. The knees are the first to suffer.

Symptoms of joint damage:

• Swelling around the kneecap.
• Rash on the legs.
• Severe knee pain.
• Deterioration of joint performance.

Then the inflammatory process from the knees spreads to the adjacent joints. It is difficult to cope with developing changes, they are often irreversible.

Read more: Joint diseases - types, causes, symptoms and treatment

Damage to the organs of the digestive system

With vasculitis, the vessels of the mesentery and intestines can be affected. This contributes to the development of internal bleeding.

Violation symptoms:

• Severe abdominal pain that gets worse 30 minutes after eating.
• Nausea and vomiting.
• Diarrhea with blood impurities.

As the disease progresses, the likelihood of intestinal atrophy with rupture of its walls increases. The larger the lesion, the higher the likelihood of peritonitis.

Vasculitis causes

The etiology of vasculitis is poorly understood. This pathology is often associated with a variety of viral infections and immune diseases. Often, vasculitis causes an allergic reaction to certain medications.

Vasculitis can develop as a complication of previous infections. In this case, the body has an abnormal response of the immune system to infection, as a result of which the blood vessels are destroyed.

The precursors of vasculitis can also be chronic or chronic autoimmune diseases (glomerulonephritis, reactive arthritis, inflammation of the thyroid gland, systemic lupus erythematosus, Schwarz-Jampel syndrome, etc.)

Video: M. N. Valivach from the Pavlodar Regional Diagnostic Center will tell you about vasculitis:

Vasculitis treatment

Treatment of vasculitis is carried out depending on the underlying disease and affected organs. Primary allergic vasculitis often resolves on its own without requiring special treatment. When the disease affects organs important for life (brain, heart, lungs, kidneys), the patient needs intensive and aggressive therapy.

If vasculitis is severe, then the person is hospitalized. With a moderate illness, a person can receive therapy at home. Patients with an acute attack of vasculitis, pregnant women and children must be hospitalized. The hospital also provides treatment for hemorrhagic vasculitis.

When the disease worsens, the patient must be kept to bed. This allows you to quickly deal with the symptoms of vasculitis and stabilize blood circulation.

For the treatment of vasculitis, corticosteroids and chemotherapy in minimal doses are used. The goal of treatment is not only to restore the functions of the affected organs, but primarily to suppress the abnormal response of the immune system, which destroys blood vessels and disrupts the normal blood supply to tissues.

Taking medicines

Medicines should be prescribed by a doctor. Therapy is determined by the general health of the person. If the disease is mild, then the treatment course lasts 2-3 months. Sometimes therapy can take up to 6 months or even a year. The courses are repeated in case of relapses of pathology.

Drugs that are prescribed to patients with vasculitis:

• NSAIDs (Piroxicam, Ortofen, etc.). They can relieve inflammation, reduce joint pain, and make swelling and rashes less intense.
• Antiplatelet agents (Curantil, Aspirin). These drugs are aimed at thinning the blood. They are prescribed so that blood clots do not form in the patient's vessels.
• Anticoagulants (Heparin). The drugs interfere with the formation of blood clots, as they affect the blood coagulation system.
• Enterosorbents (Thioverol, Nutriclins). These drugs bind harmful substances in the intestines and promote their excretion. Such treatment is aimed at reducing the intoxication of the body.
• Glucocorticosteroid drugs (Prednisolone). Medicines are prescribed for severe vasculitis. They quickly relieve inflammation, as they suppress the activity of the immune system.
• Cytostatics (Azathioprine, Cyclophosphamide). If steroid hormones do not allow achieving a therapeutic effect and vasculitis continues to progress, the patient is injected with cytostatics. These are hard drugs that suppress the production of antibodies. They are used to treat cancer patients.
• Antihistamines. It can be Suprastin, Tavegil, etc. These medicines are prescribed to children if they have just begun to develop vasculitis. They help you cope with drug and food allergies.

Drug-free treatment

Blood purification procedures help to cope with the symptoms of the disease.

These are the so-called techniques of gravitational blood surgery:

• Immunosorption. This procedure aims to cleanse the venous blood. It is passed through a special apparatus containing an immunosorbent.
• Hemisorption. The blood is passed through a device that contains a special sorbent. It helps to cleanse it from immune complexes, antibodies and antigens.
• Plasmapheresis. The blood is passed through a device that cleans it or replaces it with plasma.

Power features

Vasculitis often leads to allergies. To reduce the likelihood of its occurrence, you must adhere to a diet.

The menu should not include such products as:

• Chocolate.
• Eggs.
• Berries and red fruits.
• Citrus fruits.
• Products that contain many chemicals (dyes, stabilizers, flavorings). First of all, this applies to sausages, pâté, chips, crackers.
• Mushrooms.
• Alcoholic drinks, carbonated water, tea and coffee.
• Baking.
• Salinity.
• Spicy and fried foods.
• Products to which a person has an individual intolerance.

If the patient suffers from the urinary system, then dietary table No. 7 should be observed. If the digestive organs are affected, then a dietary table number 4 is prescribed.

Unconventional treatments

If a person self-medicates, the disease will begin to progress. This poses a threat to life.

With the permission of a rheumatologist, it is permissible to use licorice root, phyto-picks (poplar buds, calendula, horsetail, peppermint, etc.) for the treatment of the disease. Sometimes hirudotherapy can reduce the intensity of symptoms.

Forecast

The prognosis of vasculitis depends on its type and the degree of damage to surrounding organs and tissues. For the treatment of this disease, it is very important to make the correct diagnosis in time and prescribe the correct drug treatment that does not cause allergic reactions and side effects.

Due to high-quality adequate treatment, the life expectancy of patients is significantly increased. If treatment was started on time, then the five-year survival rate is 90%. When therapy has been absent for a long time, this rate drops to 5%. Patients often become disabled.

The prognosis is aggravated by damage to the kidneys, brain, aorta, coronary vessels, and organs of the digestive system. Vasculitis is severe in people over 50 years old. Therefore, people with vasculitis need to closely interact with the treating doctor and strictly follow all his recommendations.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".