Vasculitis is the common name for certain diseases of the vascular system, accompanied by inflammation and destruction of the walls of blood vessels. Other names for this pathology are angiitis and arteritis. Symptoms of vasculitis resemble the signs of atherosclerosis: the walls of the capillaries, veins and arteries thicken, due to which the lumen of the blood flow is reduced and blood circulation is disturbed. Oxygen starvation occurs in organs and tissues, because as a result of circulatory disorders, their proper nutrition is no longer provided. This becomes the main cause of failures in their work.
Types of Vasculitis
There are several classifications and forms of vasculitis: the symptoms of the disease are divided into primary (occur as an independent phenomenon) and secondary (most often occur against the background of other pathologies). In turn, the manifestations belonging to the first group are divided into three types according to the type of vascular inflammation.
Inflammation of small capillaries, arterioles, venules:
- Hemorrhagic vasculitis (Shenlein-Genoch disease, allergic purpura or capillarotoxicosis), arising in the form of inflammation of the vessels of the microvasculature with a primary lesion of the skin, joints, gastrointestinal tract and kidneys. The disease can be triggered by herpes viruses, acute respiratory viral infections and influenza, as well as bacterial factors (mycoplasma, streptococci, staphylococci mycobacteria, foodborne infections). Parasitic infestations can also cause symptoms of vasculitis. Some experts believe that these and hereditary factors are needed for the development of pathology.
The mechanism of the occurrence of vasculitis is associated with the formation of immune complexes. Moving in the blood stream, they attach to the surfaces of the walls of small blood vessels and lead to its destruction and the onset of inflammation. In the process of the development of the disease, there is an increase in the permeability of the wall, the deposition of fibrin of thrombotic masses, which causes hemorrhagic syndrome and microtrombi.
- Wegener's granulomatosis, manifested in the form of ulcerative necrotic rhinitis, pulmonary tissue infiltration with decay, polymorphic skin rashes, polyarthralgia. In the process of development of Wegener's granulomatosis, several stages of the disease are distinguished. The first stage is accompanied by a clinic of purulent-necrotic or ulcerative-necrotic rhinosinusitis, laryngitis, changes in the bone-cartilaginous skeleton of the nasal septum and orbit. The second stage - pulmonary parenchyma is involved in the pathological course . In the third stage, serious changes occur in the tissues of the lower respiratory tract, digestive and cardiovascular systems, and kidneys. The fourth stage - is expressed by pulmonary, cardiac or renal failure and leads to death within a year from the onset of the development of pathology.
- Microscopic polyangiitis affects the skin, lung tissue and kidney. In the initial stages of the disease, subfebrile body temperature, general weakness, and malaise appear. In some patients, lesions of the upper respiratory tract and visual system are manifested. These effects are reversible and can be treated with immunosuppressants.
- Cryoglobulinemic vasculitis, the symptoms of which externally in each patient may manifest in different ways. Usually these are skin manifestations in the form of tissue necrosis , ulcers, gangrene.
With the development of this form of the disease, cryoglobulins are formed in the patient’s blood, which are protein compounds that, when interacting with antibodies, turn into insoluble complexes. Circulating in the bloodstream, it gets on the walls of blood vessels and eventually destroy them. It has been established that similar pathologies are more common in people suffering from hepatitis C. However, vasculitis can develop on its own, without any viruses.
- Charge-Strauss syndrome manifests itself in the form of inflammation with the involvement of the respiratory tract, can affect small and medium vessels. Symptoms and causes of vasculitis of this kind are associated with immune inflammation, thrombosis, increased permeability and fragility of blood vessels. The provocateurs here can be viral and bacterial infections, vaccinations and allergic reactions, stress, pregnancy and childbirth.
The defeat of the vessels of medium caliber:
- Periarteritis nodosa is characterized by inflammatory-necrotic changes in the small and medium visceral and peripheral arteries. Here viral infections and the body’s tendency to increase coagulation and thrombosis play a role in the development of the disease. Has a benign or malignant character. In the first embodiment, it develops slowly. Rapid development is associated with impaired renal function. Lightning-fast development of pathology occurs rarely and leads to death.
- Kawasaki disease is a rare immunocomplex inflammatory lesion of arteries of various calibers, which occurs mainly in children of the first years of life. It is also interesting that this form of the disease is most often found in representatives of the Asian race, which indicates genetic and hereditary factors for the development of the disease.
Diseases of the large vessels and arteries:
- Giant cell temporal arteritis (also called temporal arteritis or Horton's disease), affects large and medium intra- and extracranial vessels. The factors provoking this disease are viral infections (hepatitis, acute respiratory viral infections, herpes) in combination with a genetic predisposition.
- Takayasu's disease is an inflammatory lesion of the aorta and large arteries. Clinic of the course of this form of the disease: weakness, pain in the limbs, numbness and pallor of the integument, lack of pulse. There may be a difference in heart rate on the left and right hands.
The main symptoms of vasculitis can be localized both on the skin and on the internal organs. They can occur for various reasons and have varying degrees of severity. There are many types of this disease: there are vasculitis of the brain, eyes, lungs, lower extremities.
Secondary vasculitis
Secondary vasculitis occurs against the background of progressive infectious and oncological neoplasms. This form of the disease must be treated by an infectious disease specialist or oncologist, respectively, before relieving the exacerbation. If treatment by a specialist was not effective enough, you need to contact a rheumatologist for further examination.
Vasculitis: what is this disease?
Doctors mostly associate the causes of the disease with impaired immune activity caused by the appearance of an infectious agent. The inflammatory process that occurs with systemic diseases of this kind affects the layer of the vascular wall.
The disease is destructive in nature: it violates the patency of veins and capillaries, and also causes their microcirculatory disorders. As a result of a lack of oxygen and nutrients, in most cases it ends with ischemia of organs, the occurrence of necrosis or heart attack.
Different forms of this pathological process can occur in people of different ages. So, for example, symptoms of hemorrhagic vasculitis (the causes most often become transferred infectious diseases), occur in children from 4 to 14 years. Signs of periarteritis nodosa occur mainly in the male population from 30 to 50 years. Horton's disease often affects older people. Kawasaki disease occurs in children under 5 years of age, and more often manifests itself in people of the yellow race. Takayasu disease most often affects people under 40 years old.
With secondary vasculitis, the treatment of symptoms (the cause is the presence of another inflammatory process in the body) can be complicated. Especially often, such manifestations occur in middle-aged men.
Clinical manifestations of systemic vasculitis usually occur in the form of various forms of fever, fever, weakness, loss of appetite and a sharp decrease in weight. To these manifestations are added symptoms characteristic of the defeat of certain systems.
Vasculitis: causes, symptoms
The exact causes of this disease have not been established. Among doctors, there is an opinion that this ailment is genetic in nature and inherited through several generations. Here, the occurrence of autoimmune disorders in the body and infection by pathogenic microorganisms play a negative role.
It is believed that the main symptoms of vasculitis can occur due to allergic reactions of the body, after vaccination, after serious injuries, hypothermia and poisoning by chemical and radioactive substances.
In this case, the symptoms of the disease with damage to various organs and systems of the body can have a variety of manifestations:
- With lung damage, shortness of breath appears, coughing attacks, suffocation and hemoptysis episodes.
- With kidney damage, there will certainly be swelling and increased blood pressure.
- Lesions of the skin will be manifested in the form of rashes, ulcers, gangrene. Common symptoms of vasculitis are blue or white fingers.
- With damage to the mucous membranes, the appearance of ulcers and rashes is observed.
- With damage to the musculoskeletal system, severe muscle and joint pain, swelling.
- Eye damage is accompanied by redness and pain in the eyes, loss of vision.
- Pathological processes in the ENT organs are accompanied by discharge and bleeding from the nose and ears, hoarseness of the voice, deformation of the back of the nose, hearing loss and smell.
- The processes affecting the nervous system are accompanied by convulsions, tremor of the extremities, dizziness, seizures, impaired motor function.
- With lesions of the digestive system, abdominal pain, diarrhea are observed, blood may be present in the stool.
- With lesions of the cardiovascular system, the symptomatology is accompanied by pain behind the sternum, interruptions in the work of the heart, increased blood pressure, lack of pulse on the arms or legs.
Other symptoms
If you review vasculitis, you can identify the symptoms that are identical for all forms and types of the disease. Patients have an increase in body temperature, weight loss, decline in vitality.
In laboratory studies of patient analyzes, an acceleration of ESR, an increase in C-reactive protein, fibrinogen, and an increase in the number of leukocytes are often found. According to blood and urine tests, kidney damage is often detected.
Sometimes it’s very difficult to understand that it is vasculitis. Diagnosis can take a long time, because the clinic of the disease develops slowly and is often worn out.
Diagnosis of the disease
The probability of eliminating the defeat of vital organs and malfunctions in their work depends on the time period for determining the pathological manifestation, diagnosis and therapy. The main examination is prescribed by a rheumatologist, however, if necessary, consultations of other narrow-profile specialists (ophthalmologist, neurologist, otolaryngologist, etc.) can be prescribed.
Diagnosis of vasculitis (symptoms, signs, causes of a possible disease are carefully studied in the form of physical examinations) occurs only when studying laboratory tests. When determining the disease, the age of the patient is taken into account, clinical and laboratory results of the studies are compared, other diseases are excluded.
When taking blood from a patient, nonspecific indicators of moderate inflammation are usually found: accelerated ESR, increased C-reactive protein, fibrinogen, increased number of white blood cells, platelets and eosinophils. In a biochemical blood test, an increase in immunoglobulin A and CRP is noted. According to urine tests, signs of hematuria, proteinuria, and cylindruria are determined.
The presence of a pathological process may be indicated by the results of a coagulogram. The lack of data on blood coagulation disorders during the manifestation of clinical signs clearly indicates the presence of the disease.
When diagnosing this disease, a comprehensive examination of the patient is performed. Mandatory electrocardiography (ECG), echocardiography, ultrasound, radiography, and other diagnostic methods are used. To confirm the diagnosis, a biopsy of the affected tissues and their subsequent morphological study are necessary.
In severely diagnosed cases, a biopsy of the skin can be performed. As a result of histological examination in the presence of vasculitis, deposits of A and CIC on the endothelium and in the vascular walls of the veins, arteries and capillaries themselves, the exit of blood particles outside the vascular system and the appearance of microthromboses are most often detected.
Treatment features
Vasculitis, in all its manifestations, is treated according to the general scheme of therapeutic effects. A common feature here is the use of immunosuppression drugs. Medicines of this direction do not allow the immune system to kill its own healthy cells. Additionally, anti-inflammatory drugs can be prescribed. Usually, both directions of such therapy combine glucocorticosteroid drugs and cytostatics.
The main stages of treatment of various types of vasculitis are: suppression of the inadequate immune response of the body, conducting immunosuppressive therapy, correction of disorders in the body and further rehabilitation.
Drug therapy of such pathologies includes an anti-inflammatory and immunosuppressive course of corticosteroid hormonal drugs. The most popular remedies here are prednisone or dexamethasone. They provide a quick elimination of edema of the vascular tissue and reduce the risk of ischemic syndromes.
Dosage forms of cytostatic effects are prescribed in the diagnosis and treatment of symptoms of vasculitis with damage to the central nervous system, disease progression, malignant renal hypertension and the ineffectiveness of hormonal therapy. These include drugs such as Cyclophosphamide. In severe forms of the disease, the use of high doses of chemotherapy based on Cyclophosphamide and prednisolone is practiced. In parallel, drugs that promote vasodilation and prevent the appearance of blood clots can be prescribed - Trental, Curantil.
Treatment regimens with the presence of anticoagulants and antiplatelet agents are prescribed for manifestations of hypercoagulation and DIC. In cases of peripheral microcirculation disorders, nicotinic acid and its derivatives are prescribed. In addition, angioprotectors, vasodilators, calcium channel blockers are used in the treatment of symptoms and forms of vasculitis (caused by immune disorders).
Effective methods in the treatment of systemic vasculitis is the conduct of hemocorrection sessions, allowing to remove circulating agents and immune complexes from the blood. In the complicated course of such pathologies, a coordinated collaboration of a rheumatologist, nephrologist, pulmonologist, otolaryngologist, neurologist, surgeon, ophthalmologist and other specialists is required.
Plasmapheresis, heme oxygenation and ultraviolet irradiation of blood are modern methods of treating diseases of this kind.
Unconventional techniques
Alternative medicine offers the use of various herbs and infusions as a treatment for the symptoms and causes of vasculitis with folk remedies. Here are some good recipes:
- Mix the mixture of elderberry, yarrow, Japanese sophora berries and dried nettles in equal proportions. Take 8 tablespoons and pour a liter of boiling water, insist for an hour, strain and consume 1 glass three times a day.
- Grind and mix in equal amounts inflorescences of calendula, elderberry, mint leaves, poplar buds, yarrow and horsetail. Brew boiling water in half a liter, insist for an hour and consume half a glass twice a day.
- People who know firsthand what kind of disease it is - vasculitis, recommend making herbs of tansy, wormwood, immortelle, elecampane and insist in a thermos. The prepared mixture is consumed in 3 tbsp. tablespoons twice a day before meals.
- It relieves allergic manifestations of vasculitis badanella well: pour 40 grams of dried and chopped herbs up to 0.3 liters of boiling water and insist overnight. Add honey and drink like tea.
- Licorice tincture, in which natural corticosteroids are present, is used 5 times a day for 1 spoon.
- When vasculitis is often recommended, a decoction of a mixture of plantain, buckwheat, wild rose, blackcurrant, St. John's wort and mountaineer.
- Nettle squeezed juice is also effective in treating vasculitis symptoms and preventing the disease.
With manifestations in the form of subcutaneous hemorrhages, it is recommended to make compresses from pine resin. To do this, heat a glass of the product in a water bath, mix 3 tablespoons of beeswax and 40 grams of any vegetable oil. The resulting composition is stirred until homogeneous, cooled and applied in the form of compresses overnight.
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The prognosis of systemic vasculitis
Mild vasculitis resolves on its own. More complex pathologies require medical treatment under constant medical supervision. With the rapid development of the disease, the patient may die within a few days after the onset of the disease, and this is usually associated with damage to the vessels of the central nervous system and intracerebral hemorrhage.
Disease prevention
Prevention of symptoms of vasculitis comes down to their prevention and elimination of the main manifestations. To do this, it is recommended to harden and strengthen the body in every way. Improving gymnastics, swimming, regular walking in the fresh air, moderate physical activity, healthy nutrition, timely treatment of any diseases, abandonment of bad habits, compliance with the work regime and good rest - these are the main methods of preventing the disease.