Vasculitis: what is this disease, how to treat, symptoms, causes

Author Ольга Кияница

2018-09-21

Vascular disease can occur almost imperceptibly or with the development of severe complications. In such cases, the main thing is to start treatment on time, which depends a lot on the correctness of the diagnosis. The symptoms of various forms given in the material will help to notice the onset of the disease on time and consult a doctor.

Vasculitis is a group of disorders that are directly related to the destruction of blood vessels during the development of inflammation. Both arteries and veins can be involved in the pathological process. Lymphangitis in some cases is considered a variant of vasculitis.

The development of vasculitis is mainly associated with the migration of leukocytes, as a result of which characteristic damage to the blood vessels occurs.

Inflammation of the veins (phlebitis) or arteries (arteritis) are separate diseases, although both pathologies occur during vasculitis. There are many different types of vascular inflammation, and in each case the most inherent symptoms are determined and appropriate treatment is carried out.

Video: What is vasculitis, diagnosis and treatment of vasculitis

Description

Vasculitis (lat. Vasculum - vessel, -itis - suffix denoting inflammation) means “inflammation of the blood vessels”. The disease in medical terminology is also known as arteritis and angiitis.

Inflammation is the natural response of the immune system to traumatic tissue damage or the introduction of infectious agents. Such a protective reaction is characterized by local tissue edema, which can sometimes help the body cope with the invasion of microbes.

With vasculitis, for some reason, the immune system attacks the healthy blood vessels, causing them to swell and collapse. This may be caused by an infection or medication, although often the cause is not definitively established.

Vasculitis can range from a minor problem that affects only the skin, to more serious diseases that can cause problems with vital organs like the heart or kidneys.

The main division of vasculitis is primary and secondary.

  • Primary vasculitis occurs due to an inflammatory process that directly affects the vessels themselves.
  • Secondary vasculitis is accompanied by inflammatory lesion of blood vessels on the background of another (main) disease.

Primary systemic vasculitis is also isolated - an autoimmune disease that occurs without any known cause, although a genetic predisposition may make some people more susceptible.

Types of Vasculitis

There are many types of vasculitis, among which eosinophilic granulomatosis with polyangiitis is not uncommon.The disease, also called Churg-Strauss syndrome, is a type of vasculitis that mainly affects adults between the ages of 30 and 45.

Against the background of vascular lesion by improperly induced eosinophils, the following may occur:

  • asthma;
  • allergic rhinitis (allergic cold-like symptoms);
  • high fever (fever);
  • pain in muscles and joints;
  • fatigue;
  • loss of appetite and weight loss.

Vasculitis can also affect the nerve fibers, causing weakness, tingling, or numbness. In severe cases, it damages the kidneys or the heart muscle.

Usually pathology is treated with steroid drugs.

Giant cellular arteritis is a type of vasculitis that often affects the arteries in the head and neck. Mostly defined in adults over 50 years old.
Pathology is sometimes called temporary arteritis.

In severe cases, the disease can cause:

  • pain and tenderness in the neck and head;
  • jaw muscle pain while eating;
  • double vision or loss of vision;

Pathology is also commonly found along with rheumatic polymyalgia, when various muscles begin to ache.

The main treatment is steroid drugs.

Granulomatosis with polyangitis , also called Wegener's granulomatosis, is a type of vasculitis that mainly affects the blood vessels in the nose, sinuses, ears, lungs and kidneys. The disease is most often defined in people of middle or old age.

In the absence of timely treatment, the course of the disease may complicate:

  • high fever (fever);
  • night sweats;
  • sinus inflammation (sinusitis);
  • nosebleeds and a crust in the nose;
  • shortness of breath and coughing up blood;
  • kidney problems.

This serious disease can be fatal, as it often leads to organ failure. This tim of vasculitis is usually treated with steroid drugs or other drugs that reduce the activity of the immune system.

Schönlein-Henoha purpura is a rare type of vasculitis that is common in children and can affect the skin, kidneys, or intestines. It is believed that the pathology is caused by the body's response to infection.

In advanced cases, it can cause:

  • a rash that looks like small bruises or reddish-purple spots;
  • joint pain;
  • stomach ache;
  • diarrhea and vomiting;
  • blood in urine or feces.

It usually proceeds without serious consequences and tends to improve without treatment.

Kawasaki disease is a rare disease that can occur in children under five years of age. The main cause is infection, although it is not always possible to reliably determine.

Main manifestations:

  • high fever (fever) that lasts more than five days;
  • rash;
  • swollen glands in the neck;
  • red fingers or toes;
  • Red eyes;
  • redness of the lips, tongue or mouth.

Kawasaki disease can affect the coronary arteries, blood vessels that supply blood to the heart, so some children have problems with the work of this organ.

Typically, the disease should be treated in the hospital with aspirin and special immunoglobulin therapy.

Microscopic polyangiitis is a rare and potentially serious long-term type of vasculitis that most often develops in middle-aged people. It can affect any organ, but especially affects the lungs, kidneys and nerve fibers.

Main manifestations:

  • rash;
  • shortness of breath and coughing up blood;
  • red and sick looking eyes;
  • tingling or numbness;
  • kidney problems.

This type of vasculitis is usually treated with steroid drugs or other drugs that reduce the activity of the immune system.

Polyarteritis nematosis is a rare type of vasculitis that particularly affects the arteries that feed the intestines, the kidneys and the nerves. It tends to develop in childhood or in middle-aged people. Sometimes it can be caused by an infection, such as hepatitis B, but the exact cause is unclear.

Main manifestations:

  • pain in muscles and joints;
  • abdominal pain (abdominal cavity), especially after eating;
  • rash;
  • tingling or numbness;
  • bleeding and ulcers in the intestines.

Pathology can be very serious if there is no treatment.

Therapy is based on steroid drugs, and sometimes other drugs that reduce the activity of the immune system.

Diagnostics

Most of the procedures used during the examination and treatment of a patient with vasculitis are carried out in the diagnosis and treatment of other diseases, so they are not specific to vasculitis. However, reliable and accurate diagnosis of vascular inflammation is impossible without them.

During the examination of the patient using various modern methods.

  • Abdominal Ultrasound

It is based on the use of sound waves, with the help of which a picture of organs and anatomical structures located in the stomach is created. This test can show if there are abnormalities in the abdominal cavity.

  • Angiography

This method allows you to assess the structure and passage of blood vessels, resulting in identified blockages, inflammation or other abnormalities. There are many ways to do angiography. Ultrasound is most often used to inspect large vessels without using x-rays or dyes. Magnetic resonance imaging (MRI) uses a magnetic field to create detailed images of some blood vessels and, if necessary, can be combined with special dyes (contrast agents) introduced to the patient by injection. With the help of computed tomography (CT), which uses X-rays, the structure of blood vessels is evaluated. Usually it is carried out with the use of contrast dyes. Scanning positron emission tomography (PET) requires the injection of radioactive drugs and can be useful in determining the sites of inflammation of blood vessels.

  • Biopsy

During the procedure, a small section of tissue is taken from the affected area or organ, such as the skin or kidney. Then the tissue under the microscope examines the pathologist. If necessary, special tests can be carried out to identify the disease affecting the organ.

  • Bronchoscopy

The procedure during which the doctor examines the patient's airway (trachea and bronchi). The purpose of the study is to determine the area of ​​damage, biological samples can also be collected for biopsy or flushing. This allows you to specify the cause of the disease, especially if it developed due to infection. The trachea and bronchi are the main tubes that carry air to the lungs. A fiber-optic bronchoscope (thin, flexible, with a telescope at the end) is commonly used.

  • Computed Tomography (CT)

Gives more information about the internal organs than conventional radiography (X-ray).

  • DEXA scan

Also known as dual-energy x-ray absorptiometry. This is a test that allows you to measure bone density. It can be used to identify or monitor the strength of bone tissue, especially in the long-term treatment of patients with steroid drugs.

  • Electrocardiogram

A simple and painless diagnostic method for recording the electrical activity of the heart. Often, it provides useful information about the state of the heart and can provide information that the organ is associated with vasculitis.

  • Electromyography

Electrical muscle stimulation is evaluated (usually in the arms or legs), which makes it possible to find evidence of abnormal muscle function, for example, in vasculitis. Often the test is performed in conjunction with the study of nerve conduction.

  • Echocardiography

Ultrasonic test using sound waves to create images of the heart. The study indicates the size and shape of the heart, as well as the order of the chambers and valves.

  • Positive emission tomography

The study is also known as PET scanning. In the course of the meeting, three-dimensional images are taken that show the level of metabolic activity, which is an indicator of inflammation.

  • Spirometry

Refers to lung function tests. The volume of the lungs, the amount of air inhaled and exhaled are determined, and how well oxygen is transferred from the lungs to the blood. This can be useful for monitoring patients whose lungs or airways have been affected by vasculitis.

  • Tracheostomy

Tracheostomy is sometimes necessary for patients whose main airways are blocked or narrowed as a result of damage caused by vasculitis. This provides direct access to the trachea by making a surgical opening in the front of the neck. As a result, air enters directly into the lungs, which allows patients to breathe properly when the upper respiratory tract is blocked.

Tracheostomy can be a temporary measure, especially for patients who are severely ill with vasculitis. It can also be used continuously if irreversible changes occur in the body. Patients with permanent tracheostomy insert a special tube that holds the hole open and allows normal speech. This allows you to live a more or less normal life.

  • Analysis of urine

A simple but very important urine quality test allows you to identify abnormal levels of protein or blood cells in your urine.If these symptoms are identified, then kidney damage is diagnosed.

Treatment directions for vasculitis

  • Plastic surgery on vessels

Treatment of constricted, healed, or “dangling” blood vessels involves the expansion of one or more narrowed arteries so that blood can more easily flow through the organ or limb that it feeds. A stent may also be part of an angioplasty. In this case, a narrow metal tube is inserted into the blood vessel at the site of constriction and straightens, which helps open the blood vessel and prevent re-contraction.

  • Anticoagulant Therapy

In order to thin the blood, anticoagulants are prescribed. With their help, the risk of thrombosis and vascular occlusion is reduced.

Patients taking anticoagulants, such as warfarin, should be aware of the importance of periodically checking blood clotting. This will avoid complications in the form of unforeseen bleeding.

  • Antihypertensive treatment

Based on taking drugs that allow you to control blood pressure. It is necessary if the patient has hypertension. In general, blood pressure should be controlled in all cases of vasculitis. The occurrence of hypertension with vasculitis can cause kidney damage.

  • Dialysis

When the kidneys do not work properly and eliminate toxins from the body, acids and fluids accumulate. The dialysis process helps cleanse the blood and support patients with severe renal failure. Sometimes this treatment is carried out temporarily (in a few days, weeks or months), which allows the kidneys to recover in the presence of reversible damage.If the kidney damage is not reversible, dialysis treatment is performed continuously. For patients requiring long-term dialysis, the procedure is done at home or on an outpatient basis.

  • Plasma exchange or plasmapheresis

This treatment is sometimes used in patients with severe vasculitis when antibodies are thought to play an important role in causing the disease. Treatment involves removing antibodies from the blood with the aid of an apparatus and returning the “purified” blood back to the patient’s bloodstream. It may require the transfer of blood products to the patient, including plasma, albumin or immunoglobulin. Medications can also be used to clean the blood and prevent it from clotting in the machine.

  • Vaccination

Patients with vasculitis, especially immunocompromised, should not receive live vaccines. If you take drugs against influenza and pneumonia, they are not live vaccines, therefore, are recommended for use in patients with vasculitis.

Video: Vasculitis - treatment of vascular disease


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