Vasculitis - diagnosis and therapy

What symptoms does the disease show?

The symptoms and signs of vasculitis are very different and sometimes so unspecific at least in the beginning that it often takes some time until the diagnosis is made. Common symptoms or diseases are:

  • Fever and weight loss, malaise (as a sign that there is a systemic disease and inflammation)
  • Smaller (purpura) or larger, sometimes oddly shaped bluish-red skin spots (as a sign of increased vascular fragility)
  • Joint or muscle pain (if the inflammation takes place there)
  • Inflammation of various nerves, eye inflammation
  • Stroke, heart attack, high blood pressure, circulatory disorders of the legs (arterial occlusive disease)
  • Severe nosebleeds, sinus infections, coughing up blood (especially in Wegener's granulomatosis), allergy (with Churg-Strauss syndrome)
  • Abdominal pain, blood in the stool
  • Inflammation of the renal corpuscles (glomerulonephritis)
  • Leg ulcers (in cryoglobulinemia)

How is the diagnosis made?

After questioning and physical examination, the doctor will first take blood. In particular, the inflammatory parameters are increased, depending on the involvement of the organ also corresponding blood values ​​and the blood picture are changed. In addition, autoantibodies, especially ANCA, are determined.

Further examinations such as an X-ray contrast representation of the vessels (angiography) or a computed tomography are based on the suspected diagnosis; the final diagnosis can only be made with a tissue sample from an affected vessel.

Other causes of the changes, for example malignant tumors, infections with blood poisoning or coagulation disorders, must be excluded.

What is the therapy for vasculitis?

The treatment of vasculitis should be best done in a specialized clinic. At the center of the treatment is the suppression or modulation of the immune reaction in order to contain the inflammation. This is usually done first by the administration of cortisone preparations. In more severe cases, stronger immunosuppressant drugs such as azathioprine, immunoglobulins, interferons and / or low-dose chemotherapeutic agents (cytostatic drugs) such as methotrexate or cyclophosphamide may also be used.

In certain severe forms of vasculitis, such as Wegener's granulomatosis, so-called biologicals (artificially produced antibodies) such as rituximab can also be used. If vital organs are involved, a blood plasma exchange (plasmapheresis) may be necessary.

Vasculitis: what can I do myself?

Diseases caused by the vascular inflammations, such as a heart attack, are additionally treated. A self-therapy or preventive measures (except giving up smoking) are unfortunately not possible. An omega-3 rich diet or the intake of fish oil capsules may be expected to have a positive effect on vasculitis.

What are the course and prognosis?

Even with necrotizing vasculitis, the prognosis with optimal therapy is relatively good. The risk of myocardial infarction and kidney failure is particularly high after a longer period of illness, and in the case of giant cell temporal arteritis for blindness.

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