Vasculitis Disorders: Symptoms, Causes and Treatment

Vasculitis is the name given to a group of conditions that cause inflammation of the blood vessels. This inflammation can thicken and narrow the vessel walls, restricting blood flow and, in more serious cases, damaging the organs and tissues that vessel supplies. At Renew Skin & Health Clinic, our consultant led rheumatology service focuses on identifying the specific type of vasculitis involved and building a plan that reflects how it is affecting you.

Because vasculitis covers many different conditions, ranging from mild and skin limited to serious and organ threatening, an accurate diagnosis from an experienced rheumatologist matters from the very start.

Vasculitis develops when the immune system mistakenly attacks the walls of blood vessels, causing them to become inflamed, thickened and narrowed. It can affect blood vessels of any size, from the large arteries branching from the heart to the smallest capillaries in the skin. Because so many different vessels and organs can be involved, vasculitis symptoms vary widely between patients and between the different types of vasculitis.

Some cases are triggered by an infection or another underlying condition, though in many patients no clear trigger is ever found. What all types share is ongoing inflammation within the vessel wall, which is why early specialist assessment helps limit lasting damage.

Patients with vasculitis describe a wide range of symptoms, and the pattern often depends on which vessels are affected. Common features include:

• Persistent tiredness, fever or unexplained weight loss
• Joint and muscle pain
• A vasculitis rash, which can appear as small bruise like spots, raised purple marks or open sores on the skin
• Numbness, tingling or weakness affecting the hands or feet
• Breathlessness or a persistent cough
• Abdominal pain
• Changes in urine, including blood in the urine

Because these symptoms overlap with many other conditions, a thorough rheumatology assessment is the only reliable way to confirm whether vasculitis is present and, if so, which type.

Vasculitis covers many different conditions, and vasculitis symptoms vary depending on which blood vessels and organs are affected. Some types can cause a vasculitis rash, while others mainly involve the lungs, kidneys or nerves. The table below gives a quick comparison, with more detail on each type underneath.

Giant cell arteritis, also called temporal arteritis, causes inflammation in the arteries around the temples and scalp. It mainly affects people over 50. Typical giant cell arteritis symptoms include a new headache, a tender scalp, jaw claudication and, in more serious cases, sudden changes in vision. Temporal arteritis symptoms can come on quickly, so anyone with vision changes needs to be seen the same day. Giant cell arteritis treatment aims to bring the inflammation under control quickly to protect eyesight. Your consultant will also keep an eye out for related conditions such as polymyalgia rheumatica.

Takayasu arteritis is a rare type of vasculitis that inflames the aorta and its main branches. It is seen most often in younger women. Reduced blood flow can cause pain or coldness in the limbs, so a careful assessment of the blood vessels is an important part of diagnosis.

Polyarteritis nodosa affects the medium-sized arteries supplying the gut, kidneys and nerves. In some patients it follows an underlying infection, though often the exact cause is not identified, and a coordinated assessment helps guide the right treatment approach.

Granulomatosis with polyangiitis, previously known as Wegener’s granulomatosis, is a form of GPA vasculitis that typically affects the nose, sinuses, lungs and kidneys. It is one of several conditions grouped together as ANCA-associated vasculitis, and prompt diagnosis matters because untreated GPA can affect how well the organs function.

Microscopic polyangiitis is another ANCA-associated vasculitis, most often affecting the kidneys, lungs and nerves. Like GPA, it usually needs prompt specialist assessment and ongoing monitoring.

Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg Strauss syndrome, usually develops in adults who have asthma or an allergic condition such as allergic rhinitis. Because it often follows respiratory symptoms, your consultant will assess both the lungs and the wider immune system.

Henoch Schönlein purpura, also known as IgA vasculitis, is one of the more common forms of vasculitis and is seen more often in children than adults. Many cases settle without long-term problems, though ongoing monitoring is important where the kidneys are affected.

Cryoglobulinaemic vasculitis (also spelt cryoglobulinemic vasculitis) occurs when abnormal proteins in the blood, called cryoglobulins, cause inflammation in the small blood vessels. It is sometimes linked to a viral infection.

Behçet’s disease is a type of vasculitis that can affect blood vessels of any size. It is seen more commonly in people with family origins in the Mediterranean, Middle East and parts of Asia. Because symptoms can flare and settle over time, ongoing specialist review helps keep the condition well controlled.

Your consultant will begin by taking a detailed history and examining you. Blood tests are then chosen to suit your symptoms, rather than being a standard set for everyone. The results may be described as a vasculitis blood test or vasculitic screen bloods, and further investigations may be arranged if needed.

The table below shows the blood tests most commonly arranged. Which ones you need depends on the type of vasculitis suspected.

Step 1: Initial Consultation – Your first appointment begins with a detailed discussion of your symptoms, medical history and any concerns you have, followed by a clinical examination.

Step 2: Investigations – Where appropriate, blood tests, imaging or a referral for further investigations are arranged to help confirm the diagnosis and identify which vessels are involved.

Step 3: Diagnosis and Treatment Plan – Your consultant explains the findings in plain language and discusses the treatment approach best suited to your individual circumstances.

Step 4: Ongoing Care – Regular follow up appointments allow your consultant to monitor your progress and adjust your treatment plan as your condition changes.

Depending on the type and severity of vasculitis you have, your plan may draw on:

• Medication management
• Long term monitoring for inflammatory and autoimmune conditions
• Referral for specialist investigations or onward care where these are needed
• Practical lifestyle guidance to support your overall treatment plan

No two patients receive an identical plan, because no two cases of vasculitis behave the same way. Where prescription treatment could help, your consultant explains the options in full during your consultation, and nothing is prescribed until a complete assessment has taken place. How well any individual responds varies from person to person, and results are never guaranteed. The aim of every plan is to bring inflammation under control and protect your organs for the long term.

Your care is led by Dr Ganesh Kasavkar, MBBS, MRCP, Rheumatology and General Internal Medicine (CCT), GMC Reg. No. 7436153. Dr Kasavkar has over 10 years of experience in Rheumatology and over 15 years in General Internal Medicine, and works as a full time consultant rheumatologist at a major NHS teaching hospital.

He is a member of a vasculitis multidisciplinary team and has particular exposure to giant cell arteritis through regular on call work and a dedicated giant cell arteritis management pathway. His academic work includes a review of temporal artery biopsy referrals in suspected giant cell arteritis and a published case report on vasculitis linked to contaminated recreational drug use. Dr Kasavkar is committed to patient centred care, involving every patient fully in decisions about their own treatment plan.

Renew Skin & Health Clinic is a CQC registered clinic offering consultant led rheumatology assessment for the full range of vasculitis disorders. We combine genuine specialist expertise with a calm, supportive environment, helping you feel informed and confident at every stage of your care.

Your consultation fee covers your appointment with our consultant rheumatologist. Blood tests, scans and any other investigations are priced separately, and we always discuss the cost with you before they are arranged. Full details are on our Price List

If you have noticed a persistent rash, unexplained fatigue, joint pain or any of the symptoms described above, contact Renew Skin & Health Clinic today to arrange a consultation with our consultant rheumatologist. Early, expert assessment can make a genuine difference to how your condition is understood and managed going forward. Speak to our team now to find a time that suits you.

Renew Skin & Health Clinic

18 Guy Street, Royal Leamington Spa, CV32 4RT
Telephone: +44 1926 422 454 · Email: info@renewskinandhealthclinic.co.uk