What is vasculitis and what are its main types?

Vasculitis, also known as angiitis, is a medical condition characterized by inflammation of the blood vessels in the body. This inflammation occurs when the body's immune system mistakenly attacks the blood vessels. Vasculitis can affect arteries, veins, and capillaries, which are the vessels that carry blood from the heart to the organs, return it to the heart, and connect small arteries and veins, respectively [1].

When blood vessels become inflamed, their walls may narrow, restricting blood flow, or they may become completely blocked. In some cases, vessel walls may stretch and weaken, leading to the formation of a bulge known as an aneurysm. If this aneurysm ruptures, it may cause serious internal bleeding in the body [1].

Causes and Risk Factors

Vasculitis can occur for several reasons, including infection, certain medications, or other underlying diseases. However, the cause is often unknown. Some other medical conditions can trigger vasculitis, such as certain infections (e.g., Hepatitis B or C), autoimmune diseases (e.g., lupus), and certain types of cancer (e.g., lymphoma) [2].

Vasculitis can affect anyone of any age, but some types are more common in specific age or gender groups. For example, giant cell arteritis typically occurs in people aged 50 and older [2]. Additionally, certain lifestyle habits, such as smoking and the use of illicit drugs, can increase the risk of developing it [2].

Common Types of Vasculitis

There are many types of vasculitis, and they vary in the vessels they affect and the organs involved. Common types that can affect the nervous system include:

• Giant Cell Arteritis: Often affects the aorta and its main branches, including the temporal and ophthalmic arteries. It typically affects people over 50 and may cause severe headaches and vision problems [2].
• Takayasu's Arteritis: Affects large arteries such as the aorta and its branches. It often affects young women between 20 and 40 and may cause strokes and vision problems [2].
• Polyarteritis Nodosa: A rare disease that can occur at any age but usually appears between 40 and 60. It commonly affects medium-sized arteries and may cause muscle and joint pain, kidney failure, and high blood pressure [3].
• Primary Angiitis of the Central Nervous System: A rare disorder limited to the brain and spinal cord, including symptoms such as headaches, behavioral changes, and seizures [2].
• Kawasaki Disease: A rare form of vasculitis that affects children under the age of 5 and can cause inflammation in the coronary arteries [2].

Common Symptoms

Symptoms of vasculitis vary based on the affected blood vessels and their location in the body. However, general symptoms commonly include fever, swelling, and a general feeling of being unwell [1]. Other symptoms may include rapid weight loss, joint and muscle pain, skin rashes, and issues with the kidneys or other organs [2].

If the nervous system is affected, symptoms such as persistent headaches, confusion, vision problems (e.g., double or blurred vision), numbness or paralysis of the limbs, and seizures may occur [2]. In certain cases, such as giant cell arteritis, a new severe headache and jaw pain while chewing may be warning signs that require immediate medical attention to avoid vision loss [2].

Diagnosis and Treatment

Diagnosing vasculitis can be complex because its symptoms resemble those of many other conditions. Diagnosis is based on a review of medical history, a physical examination, and the ordering of a range of diagnostic tests. These tests may include blood and urine tests to look for signs of inflammation, cerebrospinal fluid analysis, a biopsy of the affected tissue, as well as imaging tests such as CT scans, MRIs, and angiograms to assess the condition of the vessels [2].

The main goal of treatment is to stop the inflammation and control the abnormal immune system response [1]. Corticosteroids, such as prednisone, are often used to reduce inflammation, in addition to immunosuppressive drugs like cyclosporine [2]. In some cases, other procedures such as plasma exchange or surgery to repair damaged blood vessels may be required [2].

It is important to follow up with a specialist physician to evaluate the effectiveness of the treatment and adjust it as needed. Vasculitis can enter a period of remission with treatment, which is a period when the disease is not active [3]. For more information about vasculitis, you can visit Vasculitis: Types, Symptoms, Diagnosis, and Treatment (Arabic).

Medical references

• Vasculitis
• Vasculitis in the Nervous System
• Vasculitis What Is Vasculitis?