Vasculitis

Vasculitis

What is Vasculitis?

The vasculitides are a heterogeneous group of uncommon diseases characterized by inflammatory cell infiltration and necrosis of blood – vessel walls. Systemic necrotizing vasculitis can be rapidly life – threatening, so early accurate diagnosis and treatment is vital.

Vasculitis may be primary or secondary to established connective tissue disease (such as rheumatoid arthritis), infection or malignancy. The severity of vasculitis is related to the size and site of the vessels affected. Classification is based on vessel size and determines the treatment approach.

How is the course of disease?

If diagnosed early and treated aggressively, disease can be well controlled. There may be relapses in few patients which can still be managed well with the present day medication.

What monitoring needs to be done?

Blood pressure

Renal function tests

Blood counts

Liver function tests

Blood sugars and lipids for those who are on steroids

Are there any alarming symptoms?

Yes, there are few symptoms at the onset of which you need to see a physician immediately

  • Uncontrolled Blood pressure
  • Severe headache
  • Severe weight loss
  • Persistent fever
  • Abdominal pain
  • Reduced quantity of urine
  • Redness of eyes
  • Sudden blurring of vision
  • Blackish discoloration of fingers or toes
  • New onset skin lesions

How often to follow up?

You need to be seen by the treating rheumatologist monthly for initial 3 months, followed once in 3 months after stabilization and later on 6 monthly follow up is compulsory. It is important to be compliant with the medications.

Are there any complications which can be dangerous?

Yes, there can be life threatening complications affecting major organs like kidney and heart, if the medications are not taken regularly.

How about the prognosis?

With continued monitoring and minimal maintenance medications, the disease has a good outcome and life expectancy, without much of disease worsening.

What are the symptoms of Vasculitis?

Systemic

  • Malaise
  • Fever
  • Weight loss
  • Myalgia
  • Arthralgia

Skin

  • Purpura (palpable)
  • Ulceration
  • Infarction

Gastrointestinal

  • Mouth ulcers
  • Abdominal pain
  • Diarrhoea

Respiratory

  • Cough
  • Wheeze
  • Haemoptysis
  • Dyspnoea

Ear, nose and throat

  • Epistaxis
  • Crusting
  • Sinusitis
  • Deafness

Cardiac

  • Chest pain