American Medical Association Family Medical Guide - American Medical Association [638]
Vasculitis
Vasculitis is inflammation of the blood vessels that can result from an underlying illness or can occur for unknown reasons. Vasculitis can affect any of the blood vessels in the body (capillaries, arterioles, venules, arteries, or veins) and can range from mild to life-threatening. Some forms of vasculitis are more prevalent in one sex than the other, or among people of a certain racial or ethnic background. Vasculitis can lead to arteritis (chronic inflammation of the arteries). In arteritis, inflammation causes the arteries to thicken, reducing the amount of blood they can carry to organs.
Following are brief descriptions of some of the diseases that cause vasculitis. Most of these diseases are rare and their causes are unknown, but many seem to be autoimmune disorders in which an abnormal immune response attacks cells in the body.
Polyarteritis nodosa
Polyarteritis nodosa is a rare autoimmune disease in which the immune system mistakenly attacks the small and medium arteries in the body, causing inflammation. The inflammation can affect any organ but commonly affects the skin, muscles, joints, peripheral nerves, intestines, or heart. Polyarteritis nodosa is most common in people of middle age, and affects three times as many men as women. Without treatment, the disease can be rapidly fatal.
Temporal arteritis
Temporal arteritis, also known as giant cell arteritis, is chronic inflammation of the temporal artery that runs over the temple, beside the eye. The temporal arteries are branches of the carotid arteries, which supply blood to the head and brain. Temporal arteritis usually occurs after age 50 and occurs twice as often in women as in men. Temporal arteritis can impair vision and cause permanent blindness if not treated.
Takayasu’s arteritis
Takayasu’s arteritis is inflammation of the aorta (the artery that carries blood away from the heart to the organs). Takayasu’s arteritis is rare, affecting mostly Asian women under age 40.
Wegener’s granulomatosis
Wegener’s granulomatosis, sometimes called Wegener’s arteritis or Wegener’s disease, is a form of vasculitis that affects the sinuses, nose, ears, trachea, lungs, and kidneys. Wegener’s granulomatosis can occur in people of all ages, but primarily occurs during middle age.
Symptoms
The symptoms of vasculitis vary, depending on the underlying illness, the part of the body in which the affected blood vessels are located, and the severity of the damage to involved tissues. In many cases, symptoms are general and resemble those of a viral infection.
Diagnosis
To diagnose vasculitis, a doctor will take a detailed health history and perform a physical examination. Because vasculitis can resemble other diseases and therefore may be difficult to diagnose, the doctor may recommend one or more of the following tests:
• Blood test (see page 145) to look for a low red blood cell count (which can indicate anemia), a high white blood cell count (which can indicate infection), or a low platelet count (which can indicate bleeding)
• Urine test (see page 150) to detect abnormal amounts of protein and red blood cells in the urine
• Angiogram (see page 110) to detect narrow or constricted arteries
• Biopsy to detect damage to tissues
• X-ray (see page 109) to detect damage to organs
• CT scan (see page 112) to detect damage to organs
• MRI (see page 113) to detect damage to the brain or other organs
• ECG (electrocardiogram; see page 559) to detect damage to the heart
• Echocardiogram (see page 561) to detect damage to the heart
• Ultrasound (see page 111) to detect damage to organs
• Lung function test (see page 647) to measure how well the lungs are working
Treatment
The treatment of vasculitis depends on the cause of the inflammation and the severity of any organ damage. For some forms of vasculitis, no treatment