Vasculitis

Redness on the skin, inflammation, deterioration of blood circulation in the tissues – all these are signs of vasculitis. This term combines a number of diseases accompanied by inflammation of the vascular walls.

Systemic Vasculitis is a group of rheumatic diseases that differ quite significantly in the clinical picture and complaints in patients. A common process, common to all vasculitis, is inflammation of the vascular wall, which, depending on the location, leads to different results. 

What types of vasculitis exist? 

There are vasculitis of large vessels – giant cell arteritis (Horton's arteritis, temporal arteritis) and arteritis Takayasu.

Giant cell arteritis is more common in people over 50 years of age, mainly women.

Its main symptoms are: 

• severe headache,

•   sudden and acute visual impairment,

•   an increase in blood ESR and CRP (this is one of the indications for an urgent consultation with a rheumatologist).

Takayasu arteritis (also known as "no pulse disease" due to frequent cases of missing pulse in the upper extremities). It is observed in young people. The most predisposed to it are young women. The ratio of sick women to men is 8:1, and the disease usually manifests itself between 15 and 30 years.

Usually this diagnosis is not easy to establish, it is important not to forget to exclude rheumatic disease in girls with a long-term elevated ESR or temperature, when all other causes are excluded.

Vasculitis with small vessel damage includes ANCA-associated vasculitis. They are united by the presence of a special marker in the blood – antibodies to the cytoplasm of neutrophils. They affect both men and women equally. The average age of patients is 40 years.

Among these vasculites, we can discuss the presence of granulomatosis with polyangiitis (Wegener), if there is a permanent lesion of the ENT organs that does not respond to treatment with antibiotics: for example, sinusitis, otitis media, daily separation of bloody crusts from the nasal cavity in large quantities. There may also be a lesion of the lungs, kidneys.

Wegener's granulomatosis is a severe, rapidly progressive disease. Without timely treatment, it leads to a fatal outcome within 6-12 months.

Microscopic polyangiitis is characterized by damage to the kidneys, lungs, and sometimes the nervous system, often such patients first turn to nephrologists or pulmonologists.

Eosinophilic granulomatosis with polyangiitis (formerly Cherga-Strauss) it can develop in patients who have been observed for a long time for bronchial asthma, nasal polyps, and is characterized by a pronounced increase in the number of eosinophils in the blood, as well as sensitivity disorders/pain in the arms, legs, lung and kidney damage.