Vasculitis

Disease description

Vasculitides are a group of diseases in which the walls of blood vessels become inflamed. This occurs for various reasons: sometimes against the background of another illness, and sometimes without any apparent cause. Both large and small vessels of the arterial or venous system may be affected. This disease is characterized by serious complications, as all organs and systems suffer due to impaired blood supply, ischemic changes, or rupture of vessel walls. Essentially, a process of oxygen deprivation develops in the organ where inflammation or hemorrhage has occurred.

Vasculitis is a rare disease that is difficult to diagnose. Its symptoms resemble those of other autoimmune diseases, which is why it is crucial to seek help from a top clinic, where attentive doctors will carry out diagnostics and begin therapy in the shortest possible time.

Symptoms of vasculitis

Vasculitis symptoms can occur in adults regardless of gender. However, parents of children aged 4 to 12 should also be vigilant, as the risk of developing the condition (Kawasaki syndrome) increases at this age. Early signs of vasculitis may include hemorrhagic rashes, nodules or ulcers on the skin (often appearing after physical exertion or even walking), urticaria, ulcers on mucous membranes, breathing and digestive problems, as well as joint pain.

When classifying vasculitis and selecting treatment, it is important to consider which vessels are affected — large, medium, or small. Vasculitis may affect specific organs or systems. There are more than 25 types of vasculitis, including:

• Involvement of large vessels, such as Takayasu syndrome, which affects the aorta.
• Involvement of medium-sized vessels, such as Kawasaki disease.
• Small-vessel vasculitis, such as Wegener’s granulomatosis.
• Inflammation of vessels in various organs, such as the skin, gastrointestinal tract, lungs, kidneys, or CNS.
• Vasculitides arising from systemic diseases, such as sarcoidosis or lupus.

Diagnosis and treatment methods for vasculitis

Diagnosis

Blood and urine tests. This is the first and essential step in diagnosing vasculitis. Blood tests reveal elevated markers of inflammation, such as ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein). They also test for ANCA (antineutrophil cytoplasmic antibodies), which are often present in small-vessel vasculitis. A urine test may show protein or blood, indicating kidney involvement.

Imaging studies:

• Ultrasound (US). Helps assess the condition of blood vessels and internal organs. Especially useful for identifying large-vessel lesions.
• Computed tomography (CT) and magnetic resonance imaging (MRI). Used for detailed analysis of the condition of vessels and organs. These methods allow visualization of even small vessels, assessment of damage severity, and detection of ischemic changes in organs.
• Angiography. A specialized study in which a contrast agent is injected into the vessels. Angiography allows detailed visualization of changes in vessels (narrowing, dilation, or ruptures).

Modern research has shown a link between vasculitis and vitamin D deficiency, which is why checking the levels of vitamin D and calcium in the body has become a mandatory diagnostic step.

Treatment

Vasculitis is a chronic disease, so treatment is symptomatic. However, doctors in top clinics manage to control inflammation and achieve lifelong remission in most uncomplicated cases.

When vasculitis symptoms are detected, treatment in adults often begins with hospitalization. In the clinic, patients must strictly adhere to bed rest during the initial stage of treatment — until the main symptoms are eliminated. Even if internal organ involvement is not identified and hemorrhages appear only on the skin, any physical exertion may lead to vessel rupture.

Immunosuppressive therapy is the main treatment method, which includes drugs that suppress the immune system:

• Glucocorticoids. Prescribed for rapid suppression of inflammation. Effective in the acute phase of the disease.
• Cytostatics. Used to suppress autoimmune activity. Prescribed when vasculitis affects vital organs (kidneys or lungs).

Targeted therapy. One of the most modern and effective approaches to treating vasculitis, used in leading clinics around the world. Targeted drugs aim to block B-lymphocytes that trigger autoimmune processes.

Plasmapheresis. A blood purification method used in severe cases of vasculitis. The patient’s blood is cleared of antibodies and toxins, which helps reduce the inflammatory process. This method is often applied in rapidly progressing glomerulonephritis, which accompanies certain types of vasculitis.

Innovations of global clinics

CAR-T cell therapy, which has proven effective in oncology, is now also used to treat autoimmune diseases, including vasculitis. The method involves modifying the patient’s T-cells so they can recognize and destroy cells causing inflammation.