12101 Vasculitis

Overview

Vasculitis (say: vas-kyoo-LYE-tis) is a group of rare conditions that cause swelling, or inflammation, in your blood vessels. Blood vessels are the tubes that carry blood around your body – arteries, veins, and tiny capillaries. When they become inflamed, the walls of the vessels can thicken, narrow, or even form blockages, which can affect blood flow to your organs and tissues.

No, vasculitis is rare. Each type affects a different number of people, but overall it is uncommon. Some forms, like giant cell arteritis or IgA vasculitis (also called Henoch-Schönlein purpura), are seen more often than others, but all types are still considered rare.

Vasculitis can affect people of all ages, but certain types are more common in specific age groups. For example, Kawasaki disease usually affects young children, while giant cell arteritis is almost always seen in adults over 50. Some types affect males and females differently, but overall it can happen to anyone.

Symptoms

Common symptoms

• Persistent fever
• Feeling very tired (fatigue)
• Unexplained weight loss
• Muscle and joint aches
• A skin rash, which may look like purple or red spots
• Numbness, tingling, or weakness in your hands or feet
• Headaches that do not go away

Symptoms in children

• A purplish rash on the legs and buttocks
• Abdominal pain and joint swelling
• Irritability and red eyes (especially with Kawasaki disease)
• Fever that lasts more than five days

Symptoms in older adults

• A new, persistent headache and tenderness in the scalp
• Pain or stiffness in the jaw while eating
• Blurred or double vision
• Unexplained fever, tiredness, and flu-like symptoms

Causes

Main causes

• Most forms of vasculitis happen when the body's immune system mistakenly attacks its own blood vessels. This is called an autoimmune reaction.
• Sometimes a trigger, such as an infection, certain medicines, or another illness, can start this abnormal immune response.
• Often the exact cause remains unknown.

Risk factors

• Age – some types are more common in children, others in older adults.
• A family history of autoimmune disease.
• Having another autoimmune condition, such as lupus or rheumatoid arthritis.
• Certain infections that set off an abnormal immune reaction.
• Smoking may increase the risk of some forms of vasculitis.

When to see a doctor

See a doctor urgently if:

• See a doctor urgently if you have a new rash with fever, a severe headache, or trouble seeing.
• Also seek urgent care if you develop new weakness, numbness, or a change in your speech or vision.

Book a routine appointment if:

• If you have symptoms that continue or get worse over a few weeks – such as feeling very tired, losing weight without trying, joint pains, or a rash – book an appointment with your usual doctor.

Diagnosis

There is no single test for vasculitis. Your doctor will start by asking about your symptoms, past health, and family history, and then do a physical examination. Based on that, they may do several tests to look for signs of inflammation and to see which organs are affected.

Tests that may be done

• Blood tests to look for inflammation and check how well organs are working
• Urine tests to check kidney function
• Imaging tests, such as a CT scan or MRI, to look at blood vessels and organs
• A chest X-ray to check the lungs
• A biopsy – taking a very small sample of tissue from an affected area, such as skin or kidney

What to expect at your appointment

Diagnosing vasculitis can take time – sometimes weeks – because the symptoms can come and go and may look like other conditions. You might be referred to a specialist, such as a rheumatologist or dermatologist, for further tests. Let your doctor know about any new or changing symptoms, as this can help pinpoint the diagnosis.

Treatment

Treatment aims to reduce inflammation, prevent organ damage, and help you feel better. Usually, this involves medicines that calm the immune system, along with regular check-ups. The specific treatment depends on the type of vasculitis, how severe it is, and which organs are involved.

Self-care at home

• Take your medicines exactly as prescribed and keep all follow-up appointments.
• Rest when you feel tired, and pace yourself during busy times.
• Protect your skin from the sun and cold if you have a rash or sensitivity.
• Keep a symptom diary to share with your healthcare team.
• Avoid smoking and limit alcohol if you can.

Medical treatments

Doctors often start treatment with high-dose medicines that reduce inflammation quickly. These are usually corticosteroids (often just called steroids). After that, they may use other medicines that calm the immune system to reduce inflammation over the longer term. Some people need a combination of medicines. Because vasculitis can affect different organs, your treatment plan will be tailored to you. Your doctor will explain how each medicine works and what side effects to watch for. Never stop or change your medicines without discussing it with your doctor first.

When is surgery considered?

In rare cases where a blood vessel becomes seriously narrowed or blocked, surgery or a procedure called angioplasty may be needed to restore blood flow. This is not common and is only used when medication alone is not enough to protect an organ.

Living with this condition

Living with vasculitis can be challenging, but many people learn to manage it well. It's normal to have good days and bad days. Keep your healthcare team informed about how you're feeling, and don't be afraid to ask for help when you need it. Regular follow-up appointments are very important, even when you feel well.

Lifestyle tips

• Get regular, gentle exercise like walking or swimming, if your doctor agrees.
• Eat a balanced diet and try to maintain a healthy weight.
• Learn to manage stress with relaxation, breathing exercises, or hobbies you enjoy.
• Build a support network of family, friends, and health professionals.
• Get enough sleep and try to keep a steady routine.

Diet and exercise

There is no special diet that cures vasculitis, but eating a variety of healthy foods can help you feel stronger and support your body during treatment. If you take steroids, your doctor may give guidance about limiting salt and sugar. Try to stay active in a way that feels comfortable – rest when you're tired, but gentle activity can improve energy and mood.

Mental health and emotional wellbeing

Dealing with a rare, long-term condition can be stressful and may lead to anxiety or low mood. It is completely normal to feel this way. Talk to your doctor about how you're feeling – they can support you or connect you with a counselor. Also remember that with treatment, many people with vasculitis return to a good quality of life.

Prevention

Because vasculitis is usually an autoimmune condition, there is no known way to prevent it from starting. However, working with your doctor to manage your treatment plan can help prevent flare-ups and limit organ damage. This is called remission.

Vaccines

People with vasculitis can usually receive recommended vaccines, and this is often encouraged to prevent infections that could make your condition worse. Talk to your doctor or nurse before any vaccination to make sure it is safe for you.

Screening programmes

There is no routine screening test for vasculitis in the general population. If you have a higher chance because of family history or another autoimmune condition, your doctor may do regular checks of your blood pressure, kidney function, and other organs to catch problems early.

Complications

If left untreated

• Untreated vasculitis can lead to permanent kidney damage or kidney failure.
• It can cause blockages or bulging (aneurysm) of blood vessels, which may be life-threatening.
• Nerve damage can lead to numbness, weakness, or difficulty moving.
• Loss of vision is possible if the blood vessels in the eye are affected.

Long-term outlook

With the right treatment, many people with vasculitis go into remission – meaning the inflammation settles and symptoms improve. The outlook depends on the type of vasculitis, how early it is diagnosed, and how well it responds to treatment. Although vasculitis is a serious condition, advances in treatment and careful follow-up mean that most people can live a full and active life. Some may need long-term treatment, but that does not prevent them from planning for a good future.

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