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Vasculitis

Definition:

The arteries, veins and capillaries carrying the blood are also called vessels. When the vessels get inflamed, the condition is called Vasculitis. Vasculitis is an autoimmune disorder in which the blood carrying vessels are destroyed due to inflammation, thereby making them incapable of supplying adequate blood to the organs and tissues.

When a blood vessel is inflamed, it may become stretched, or weakened or enlarged or narrowed leading to insufficient blood supply which in turn causes organ or tissue damage. The walls of the blood vessels may swell and bulge, and may even rupture cause bleeding inside the body.

Vasculitis is also known as angiitis. When arteries are inflamed, it is called arteritis and when veins are inflamed, it is referred to as vasculitis.

Incidence:

Vasculitis can affect people of all ages but there are some types, which are more common in certain specific age groups.

Cause:

The exact cause of vasculitis is not known or little known. It is known to occur due to an abnormal response of the immune system, which causes inflammation of its own blood vessels. It can be triggered by infections, certain toxins, drugs, or as a reaction to certain medication, or may occur as a part of another inflammatory disease like SLE, Sjogren’s syndrome or rheumatoid arthritis, etc.

Symptoms:

Different types of vasculitis affect different blood vessels. So, the clinical presentation varies from patient to patient. Symptoms may vary depending on the blood vessel affected and the organ system involved.

  • Constitutional symptoms: Regardless of the size of blood vessels involved, patient may present with the general symptoms like fatigue, tiredness, weight loss, loss of appetite, night sweat, joint pain, etc
  • Skin: Rashes or hives on the skin, eruptions that may burst open giving rise to ulcers, nodules which may be painful, purpura, petechial hemorrhage.
  • Recurrent oral and/or genital ulcers which heal slowly and with scarring
  • Nervous System and Brain: Headaches, scalp tenderness, seizures (fits), movement abnormalities, fluctuating levels of consciousness, visual/auditory hallucinations, brain stroke, tinnitus, jaw pain, blurred or double vision and even blindness.
  • Musculo-skeletal system: Joint pain, muscular pain, swelling
  • Neurological: Tinging and pricking pain (as if pins or needles pricking), polyneuropathy (eg hand/foot drop, numbness, formication), fingers turning blue on exposure to cold (Raynaud’s phenomena), or muscle weakness or abnormal sensation followed by loss of sensation in affected part
  • Heart: may lead to hypertension, angina or myocardial infarction
  • Kidneys: It may present with proteinuria (protein in urine) and/or hematuria (blood in urine), hypertension
  • Respiratory tract: Nose bleed, nose congestion, sinus pain, recurrent cough, blood in sputum, shortness of breath, chest pain, wheezing, etc
  • Gastro-intestinal tract: Pain in abdomen, nausea, vomiting, blood in stools, perforation

Various presentations:

  • Kawasaki disease
  • Polyarteritis nodosa
  • Giant Cell arteritis
  • Cryoglobulinemia
  • Behcet's disease
  • Wegener's granulomatosis
  • Takayasu's arteritis
  • Churg – Strauss syndrome

Diagnosis:

The diagnosis of vasculitis depends on the blood vessel affected, the signs and symptoms and the physical examination. Based on that, following investigations can be done.

Investigations:

  • Blood tests:
    • CBC may reveal normoblasts, normocytic anemia
    • High level of C-Reactive Protein and ESR is indicative of underlying inflammation.
    • ANSA (Anti-Neutrophil Cytoplasmic Antibody) is positive in patients with Vasculitis
    • C3 and C4 levels are usually elevated
  • Biopsy – It is the most confirmatory test for diagnosis of Vasculitis which shows the pattern of inflammation in the affected blood vessel. Depending on the tissue affected, a biopsy can be done on skin, sinuses, lung, kidney and nerves.
  •   Angiogram – Demonstrates the characteristic inflammatory changes in the affected blood vessel
  • Urine Analysis – This test detects abnormal levels of protein or blood cells in the urine.
  • Imaging tests – Non-invasive tests like CT scan, sonography, X-rays and MRI can be done to diagnose which blood vessel and organ is affected.

Conventional Treatment:

Vasculitis is a difficult condition and there is symptomatic treatment in the conventional medicine. The conventional treatment of vasculitis is usually done by two main drugs – corticosteroids (prednisolone) and immune-suppressants (Methotrexate, Cyclophosphamide). Both act to reduce the response of immune system and thereby decrease the strength of its attack on the tissues of the body.

Homeopathic Treatment:

Homeopathy has a good scope in treating Vasculitis as it addresses the underlying abnormal immune system. Vasculitis being an auto immune disease can be treated effectively with a correctly chosen, deep acting, constitutional homeopathic medicine. Incorporating a holistic approach will boost the immune system, thereby controlling the underlying disease process and hence alleviating the symptoms of Vasculitis.

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