Vasclitis is a broad spectrum of disorders characterized by inflammation and necrosis of blood vessels. The clinical signs depend on the vessels involved and reflect loss of blood supply to tissues (ischemia) caused by blood flow obstruction.
Prognosis is also variable. For example, hypersensitivity vasculitis is usually a benign disorder limited to the skin, but more extensive polyarteritis nodosa can be rapidly fatal.
Vasculitis can occur at any age, except for mucocutaneous lymph node syndrome, which occurs only in childhood. Vasculitis may be a primary disorder or secondary to other disorers such as rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE).
CAUSES
How vascular damage develops in vasculitis isn't well understood. It has been associated with a history of serious infectious diseases, such as hepatitis B or bacterial endocarditis, and high-dose antibiotic therapy.
TREATMENT
The aim of treatment is to minimize irreversible tissue damage associated with ischemia. In secondary vasculitis, treatment focuses on the underlying disorder. Primary vasculitis is mainly treated with drugs.
Treatment may involve removal of an offending antigen or use of anti-inflammatory or immunosuppressive drugs. for example, antigenic drugs, food, and other environmental substances should be identified and eliminated, if possible.
When the vasculitis appears to be in remission or when prescribed drugs take full effect, corticosteroids are tapered down to a single daily dose and then to an alternate-day schedule that may continue for 3 to 6 months before steroids are slowly discontinued.
TYPES OF VASCULITIS
- Polyarteritis nodosa
- Allergic angiitis and granulomatosis (churg-Strauss syndrome)
- Polyangiitis overlap syndrome
- Wegener's granulomatosis
- Temporal arteritis
- Takayasu's arteritis (aortic arch syndrome)
- Hypersensitivity vasculitis
- Mucocutaneous lymph node syndrome (Kawasaki disease)