Vasculitis

Overview

Vasculitis is a general term for a group of conditions that cause inflammation of the blood vessels. Blood vessels carry blood throughout the body, including to the skin, nerves, lungs, kidneys, digestive system, brain and other organs. When a vessel becomes inflamed, it may become narrowed, weakened or blocked. This can reduce blood flow and may affect how well an organ or tissue works.

Vasculitis can involve small, medium or large blood vessels. It may affect only one part of the body, such as the skin, or several organs at the same time. Some forms develop suddenly and require urgent medical attention, while others progress more slowly and need long-term monitoring. Because symptoms can vary widely, vasculitis is often managed by a rheumatology team in cooperation with other specialists, depending on which organs are involved.

Symptoms

The symptoms of vasculitis depend on the size and location of the affected blood vessels. General symptoms may occur in many types of vasculitis and can be similar to those of other illnesses.

• Persistent tiredness or weakness
• Fever or night sweats
• Unexplained weight loss or loss of appetite
• Muscle or joint pain
• Skin rashes, purple spots, ulcers or tender lumps
• Numbness, tingling or weakness in the hands or feet
• Shortness of breath, cough or chest discomfort
• Sinus problems, nosebleeds or hearing changes
• Abdominal pain, nausea or changes in bowel habits
• Blood in the urine, swelling of the legs or changes in urination
• Headache, vision changes or jaw pain when chewing

Not every person with vasculitis has all of these symptoms. Some symptoms may be mild at first, but organ-related signs can become serious if blood flow is significantly reduced.

Causes and Risk Factors

In many cases, the exact cause of vasculitis is not fully known. It is often related to an abnormal immune system response. The immune system normally protects the body from infection, but in vasculitis it may mistakenly attack blood vessel walls, causing inflammation.

Vasculitis may occur on its own, or it may be associated with another condition. Possible contributing factors include:

• Autoimmune or inflammatory diseases
• Recent or ongoing infections
• Certain environmental exposures
• Reactions to some medicines or substances
• Family or genetic factors in some rare forms
• Age, as some types are more common in children and others in older adults

Risk factors vary according to the specific type of vasculitis. Having a risk factor does not mean a person will develop vasculitis, and many people diagnosed with vasculitis have no obvious trigger.

Diagnosis

Diagnosing vasculitis can be complex because its symptoms can resemble many other conditions. A doctor will usually begin with a detailed medical history and physical examination. They may ask about the timing of symptoms, recent infections, previous medical conditions, travel, medicines and any family history of autoimmune disease.

Tests are chosen based on the suspected type of vasculitis and the organs that may be affected. These may include blood and urine tests to look for signs of inflammation, immune system activity, kidney involvement or other abnormalities. Imaging tests may be used to assess blood vessels or affected organs. In some cases, a small tissue sample, called a biopsy, may be taken from the skin, kidney, blood vessel or another affected area to look for inflammation under a microscope.

Because vasculitis can affect different parts of the body, assessment may involve rheumatologists, nephrologists, pulmonologists, neurologists, dermatologists, ophthalmologists or other specialists. The goal is to identify the type of vasculitis, determine how active it is and check whether any organs are at risk.

Treatment Options

Treatment depends on the type of vasculitis, the severity of inflammation and which organs are involved. Some mild forms, especially those limited to the skin, may improve with careful monitoring and supportive care. More serious forms often require treatment to control inflammation and protect organs from damage.

Medical treatment usually aims to calm the overactive immune response and prevent relapses. Doctors may use anti-inflammatory or immune-modifying therapies, selected according to the patient’s condition and overall health. The treatment plan may change over time, especially as inflammation becomes controlled or if symptoms return.

Supportive care is also important. This may include monitoring blood pressure, kidney function, lung function, nerve symptoms, eye health or other organ systems. If vasculitis is related to another condition, such as an infection or autoimmune disease, that condition may also need to be addressed. Regular follow-up helps the care team evaluate response to treatment and watch for side effects or complications.

People with vasculitis are encouraged to discuss vaccinations, infection prevention, pregnancy planning, exercise, diet and long-term monitoring with their healthcare team. These topics should be individualized, as recommendations can differ from person to person.

When to See a Doctor

Medical evaluation is important if you have persistent unexplained symptoms such as fever, weight loss, ongoing fatigue, unusual rashes, numbness, shortness of breath, blood in the urine, new headaches or vision changes. These symptoms do not always mean vasculitis, but they should be assessed, especially if they are worsening or involve more than one body system.

Seek urgent medical care for sudden vision loss, severe headache, chest pain, severe shortness of breath, stroke-like symptoms, confusion, severe abdominal pain, coughing blood, rapidly spreading skin changes or a significant decrease in urination. Early assessment can help identify serious inflammation and guide appropriate care.

If vasculitis has already been diagnosed, contact your healthcare team if symptoms return, new symptoms appear or there are concerns about treatment effects. Ongoing communication and regular follow-up are key parts of managing vasculitis safely.