Vasculitis

Symptoms

Symptoms of most types of vasculitis can include:

• Fever.
• Headache.
• Tiredness.
• Weight loss.
• Aches and pains.

Other symptoms depend on the parts of the body affected:

• Digestive system. If vasculitis affects the stomach or intestines, there may be pain after eating. Ulcers and tears, called perforations, are possible. They may cause blood in the stool.
• Ears. Dizziness, ringing in the ears and sudden hearing loss may happen.
• Eyes. Vasculitis can make the eyes look red. They may itch or burn. Giant cell arteritis can cause double vision and brief or ongoing blindness in one or both eyes. This is sometimes the first sign of the disease.
• Hands or feet. Some types of vasculitis can cause numbness or weakness in a hand or foot. The palms of the hands and soles of the feet might swell or harden.
• Lungs. This can cause shortness of breath or coughing up blood.
• Skin. Bleeding under the skin can show up as red spots. Vasculitis also can cause lumps or open sores on the skin.

When to see a doctor

Make an appointment with your healthcare professional if you have symptoms that worry you. Some types of vasculitis get worse quickly. Early diagnosis is the key to getting treatment that works.

Risk factors

Vasculitis can happen to anyone. Factors that may increase the risk of certain types include:

• Age. Giant cell arteritis is rare before the age of 50. Kawasaki disease is most common in children younger than 5 years old.
• Family history. Behcets disease, granulomatosis with polyangiitis and Kawasaki disease can run in families.
• Lifestyle choices. Using illicit drugs such as cocaine can increase your risk of getting vasculitis. Smoking tobacco can increase risk of Buerger disease. This applies mainly to people assigned male at birth who are younger than 45.
• Medicines. Medicines such as hydralazine, allopurinol (Lopurin, Zyloprim) , minocycline (Arestin, Minocin, others) and propylthiouracil sometimes can cause vasculitis.
• Infections. Having hepatitis B or C can increase the risk of vasculitis.
• Immune conditions. People who have conditions in which their immune systems attack their own bodies by mistake may be at higher risk of vasculitis. These conditions include lupus, rheumatoid arthritis and scleroderma.
• Sex assigned at birth. Giant cell arteritis is much more common in people assigned female at birth. Buerger disease is more common in people assigned male at birth.

Diagnosis

Diagnosis starts with a medical history and a physical exam. You may have one or more tests and procedures. These can either diagnose vasculitis or rule out other conditions that cause some of the same symptoms. Tests and procedures might include:

• Blood tests. These tests look for signs of inflammation, such as a high level of C-reactive protein. A complete blood cell count can tell whether you have enough red blood cells. Other blood tests, such as the antineutrophil cytoplasmic antibody (ANCA) test, can look for certain antibodies. These tests can help diagnose vasculitis.
• Imaging tests. Imaging tests can show which blood vessels and organs are affected. They also can help your healthcare professional know how you respond to treatment. Imaging tests for vasculitis include X-rays, ultrasounds, CT scans, MRIs and positron emission tomography (PET) scans.
• X-rays of your blood vessels. During this procedure, called angiography, a flexible catheter resembling a thin straw goes into a large artery or vein. A special dye goes into the catheter. You have X-rays taken as the dye fills the artery or vein. The X-rays show the outlines of your blood vessels.
• Biopsy. This is a surgery in which a healthcare professional removes a small sample of tissue from the affected area of your body. Your health professional then looks at the tissue for signs of vasculitis.

Coping and support

Coping with the side effects of the medicines you take to treat your vasculitis might be one of the hardest things about living with the condition. Some of these tips might help:

• Know about your condition. Learn all you can about vasculitis and its treatment. Know the possible side effects of the medicines you take. Tell your healthcare professional about any changes in your health.
• Follow your treatment plan. Your plan may include seeing your health professional often, having more tests and checking your blood pressure.
• Eat well. Eating healthy foods can help prevent some of the problems your medicines can cause. This might include thinning bones, high blood pressure and diabetes. Eat mainly fresh fruits and vegetables, whole grains, low-fat dairy products, and lean meats and fish. If you're taking a corticosteroid medicine, ask your healthcare professional if you need to take a vitamin D or calcium supplement.
• Get vaccinations. Some medicines to treat vasculitis raise your risk of infections. These include flu, pneumonia, shingles and COVID-19. Keeping up to date on vaccinations can help. Talk with your healthcare professional about which vaccinations to get.

• Exercise most days of the week. Regular aerobic exercise, such as walking, can help prevent conditions that can be linked to taking corticosteroids. These include bone loss, high blood pressure and diabetes. Regular exercise also helps your heart and lungs.

  Many people also find that exercise improves their mood and sense of well-being. If you're not used to exercising, start out and build up slowly. Your healthcare professional can help you plan an exercise program that's right for you.

• Ask others to help. Family and friends can help you cope with this condition. You also might find it helpful to talk with others who have vasculitis. Ask a member of your healthcare team about support groups.