Vasculitis is an inflammatory condition that affects the blood vessels. The tissues of the blood vessels are damaged by inflammation caused by white blood cells attacking the walls of the blood vessels, making them weak.
Under normal circumstances, your white blood cells are part of your immune system and protect your body from infections caused by viruses and bacteria. However, white blood cells can damage healthy bodily tissues when you have an inflammatory or autoimmune condition such as vasculitis.
Vasculitis can negatively affect:
- Large blood vessels (arteries or veins)
- Medium-size blood vessels (arterioles or venules)
- Tiny blood vessels (capillaries)
Vasculitis can cause many different symptoms, and some people may not feel ill but will notice broken blood vessels and purple or red spots on their skin. Others can feel very ill, especially those with systemic symptoms and major internal organ damage.
Symptoms can include:
- Generally feeling poorly
- Muscle and joint pain
- Poor appetite
- Weight loss
How is vasculitis caused by lupus?
Lupus, also known as systemic lupus erythematosus, is an autoimmune health condition where the antibodies in your body that usually protect your system from foreign invaders such as viruses and bacteria will instead attack your own body tissues.
Once antibodies turn to attack your body, they are called autoantibodies, and they can attack any tissues of the body, including blood vessels. When this happens, it causes vasculitis, or as it is also known, inflammation of the blood vessels.
People with lupus can go on to develop vasculitis, and roughly 11% to 36% of people with lupus will develop vasculitis in some tissues to some degree. However, you can also develop vasculitis without having lupus. The two health conditions are not mutually exclusive.
Which diseases are associated with vasculitis?
Vasculitis can occur alongside many different health conditions. You can also develop vasculitis by itself without it being triggered by or associated with another health condition, virus or infection.
Some of the illnesses that can cause vasculitis are:
- erythema nodosum
- granulomatosis with polyangiitis (Wegener’s granulomatosis)
- micropolyangiitis (occurs primarily in kidneys)
- polymyalgia rheumatica
- rheumatoid arthritis
- temporal arteritis
Is lupus vasculitis serious?
This health condition can be mild and easily manageable, or it can be severe and even life-threatening. The severity of the disease will need to be determined through accurate diagnosis before the most appropriate treatment can be given.
If you suspect you may have lupus or vasculitis, you should consult a trained physician as soon as possible. Consulting with a specialist medical doctor will enable you to get an accurate diagnosis by ruling out any other causes for your symptoms, determine how severe your condition is and how it should be treated.
Does lupus cause vascular problems?
Lupus vasculitis can damage the blood vessels in the body in many ways. It can cause the walls of small blood vessels to break and cause localised bleeding in the surrounding tissues. This can present as small red or purple dots on the skin.
Should a large blood vessel become inflamed, it may swell and cause a lump or nodule that can be felt if the blood vessel is close to the skin surface. Blood vessel walls can also become narrow, causing reduced blood flow and lowering the amount of oxygen and nutrients delivered to body tissues and organs.
Narrowed blood vessel tubes can be closed entirely by blood clots forming at sites of inflammation. Should blood flow be stopped, the tissues supplied by the affected blood vessel can begin to die. For example, someone with vasculitis of a mid-sized artery in the foot may develop cold toes that are painful whenever they stand or walk. If left untreated, the condition can progress to gangrene and the loss of toes or the whole foot.
How is lupus vasculitis treated?
Once you have had a proper diagnosis from a specialist doctor, such as Dr Bhaudauria, the treatment choice will depend on several factors. These include:
- The severity of the vasculitis
- Your general health
- Your past reactions to medications
Your specialist will also determine if you need treatment or not. Some cases of vasculitis don’t need treatment, especially very mild cases that are not combined with other health conditions or symptoms.
In most cases, you will be recommended corticosteroid medications as the initial treatment for vasculitis. Those diagnosed with severe vasculitis or those who do not respond well to steroid-type medications will need alternative medicine, such as cytotoxic medication.
What is the prognosis for people with vasculitis?
There are various outcomes for people with vasculitis, and for those with mild symptoms that are limited to the skin, the condition may be annoying at most, but never goes on to be a life-threatening illness. In mild cases of vasculitis, life for the patient can carry on as usual or as close to normal as possible.
Some symptoms of vasculitis can disappear completely, only to reoccur later in life and need treatment. However, some vasculitis symptoms can be suppressed with medications and therapy to a manageable level but will never go away.
For the small number of patients that develop severe vasculitis that affects their major organs, the damage caused by the disease can happen so fast that initial treatments don’t have the time to work. In some cases the condition can be resistant to treatment, so for a small number of patients, a severe attack of vasculitis can leave them with permanent organ damage and can even be fatal.
Getting an accurate diagnosis
Booking a private consultation with Dr Bhaudauria at one of his London-based clinics can give you great peace of mind if you have symptoms of lupus or vasculitis. Specialist testing can rule out any other possible causes for your symptoms and give you an accurate diagnosis to move forward with.
The diagnosis of lupus with vasculitis is based on:
- A complete physical examination
- Body scans or x-rays
- Specialised laboratory tests
- Your current symptoms
- Your medical history
Contact Dr Bhaudauria and his team to book a private consultation. We are happy to answer any questions you may have about preparing for your consultation and what to expect from your visit.
Article by Dr. Naveen Bhadauria