The human body is indeed a marvel. Thera many organs and systems working as functions to help humans live and survive in the many environment and life changes. This makes humans a great being living in a social setting. The blood circulation system is one of the most important systems in the human body. It consists of the long blood vessels of about 40 0000 kilometres in length and heart as its engine. This fascinating system is also the main reason why when a disease strikes, it can cause discomfort symptoms, sometimes even leading to life-threatening events. Medicine may be needed in most cases affecting the blood vessel system.
One of the diseases associated with the blood vessels is vasculitis. Before going on about vasculitis, what exactly is a blood vessel? The blood vessels contain arteries, veins and capillaries. The difference in the structures of each of these structures explains its function. All arteries except pulmonary arteries carry away blood from the heart and distribute oxygen-rich blood to the body. All veins except pulmonary veins collect oxygen-poor blood throughout the body and carry the blood back to the heart. Capillaries, tiny blood vessels connecting smaller arteries to small veins, aids in the exchange of materials between the blood and tissue cells.
Vasculitis describes a group of conditions that is also known as angiitis, that damage blood vessels caused by inflammation. Vasculitis can lead to thickening and narrowing of blood vessels that result in restriction of blood flow. Eventually, it can cause damage to tissue and organs. Vasculitis can affect any part of the body, both large and small blood vessels. Damage to organs is greater if vasculitis affects the bigger blood vessels. Vasculitis can be a serious disease as it can be severe and damaging major organs.
There are 3 main underlying causes for vasculitis. The most common one is autoimmunity, followed by allergy and infections. Autoimmune disorders describe diseases that cause the immune system to react abnormally by attacking normal cells and tissues in the body. Allergies are the conditions in which the immune system reacts excessively toward substances or entities that are harmless to most people. Infection could be from bacteria, viruses and parasites. Before a person who has vasculitis is deemed to have autoimmune disease, doctors often need to rule out other causes such as allergy and infection before autoimmune is considered the cause for the vasculitis. There are certain drugs that have been associated with vasculitis such as antibiotics, anticonvulsant and non-steroidal anti-inflammatory drugs (NSAIDs).
People with vasculitis may experience symptoms such as fever, weight loss, pain and skin rash. Other symptoms depend on the part of the body affected and the severity of vasculitis. There are many types of vasculitis, each type affects different parts of the body and leads to an array of different symptoms. Below are among the common type of vasculitis:
- Anti-glomerular basement membrane disease- affecting the blood vessels in the lungs and kidneys.
- Behcet disease- commonly known as triad of oral ulcers, genital ulcers and ocular disease.
- Buerger’s disease- also known as thromboangiitis obliterans, commonly affects the arms and legs, closely linked to smoking.
- Eosinophilic granulomatosis with polyangiitis- also known as Churg-Strauss syndrome, often affects the respiratory tract, gastrointestinal tract, skin, heart and nervous system.
- Immunoglobulin A (IgA) vasculitis- formerly known as Henoch-Schonlein purpura.
- Cogan’s syndrome- inflammation of the blood vessels in the inner ears and eyes.
- Primary angiitis of the central nervous system- affecting the blood vessels of the brain, spinal cord and protective membrane covering both brain and spinal cord.
- Giant cell arteritis- also known as temporal arteritis, mostly affects the aorta and its major branches.
- Kawasaki disease- condition mainly affects children below the age of 5, often starts with high fever for more than 5 days.
- Takayasu arteritis- often affects the aorta and its branches but may affect medium-sized arteries, mainly affecting young women.
- Polyarteritis nodosa- particularly affects the arteries supplying stomach, kidneys and nerves.
- Retinal vasculitis- can cause vision problems as it affects the eye’s blood vessels.
- Hypersensitivity vasculitis- caused by reaction towards medicine and result in temporary rash.
- Rheumatoid arthritis- vasculitis associated with rheumatoid arthritis.
- Cryoglobulinemic vasculitis- often linked with hepatitis C.
Treatment aims to reduce inflammation and suppress the immune system from causing vasculitis. Treatment depends on the severity of the disease and the organs involved. If vasculitis is caused by drugs, stopping the drug can ease symptoms. Infection related vasculitis usually resolves on its own when the infection subsides. In mild cases of vasculitis affecting skin, topical steroid can ease the rash. Oral medication such as steroids, dapsone and immunosuppressants is often prescribed in persistent cases especially when involving multiorgan. Usage of intravenous immunoglobulin (IVIG) can help to control the body’s immune response. IVIG and plasma exchange are often given in severe cases. Damaged blood vessels or organs may require surgery to repair. This may include bypass grafting, sinus surgery or kidney transplant.
