Vasculitis Treatment and Causes

Vasculitis refers to a group of uncommon diseases that are all characterized by the inflammation of blood vessels. Some types of vasculitis are acute (short-term), while others are chronic (long-term). There is currently no cure for vasculitis, but early diagnosis and treatment are critical for helping to ease symptoms and hinder the progression of the disease.

Vasculitis is one of the more than 100 causes of arthritis that we treat at the Brigham and Women’s Hospital Center for Arthritis and Joint Diseases. We treat vasculitis in all of its forms, including Kawasaki disease, Behcet's disease, polyarteritis nodosa, granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis), cryoglobulinemia, Takayasu's arteritis, Churg-Strauss syndrome, giant cell arteritis (temporal arteritis), and Henoch-Schönlein purpura. All of our rheumatologists are trained and experienced in the treatment of the various vasculitic disorders. Other sub-specialists are often involved in the care of patients with vasculitis, depending on the type.

What causes vasculitis?

The cause of vasculitis is unknown in many of its forms. These types are vasculitis are referred to as primary vasculitis. Secondary vasculitis refers to forms of vasculitis that are caused by an underlying disease, such as:

  • Infections – Most cases of cryoglobulinemia are caused by the hepatitis C virus infection, and the hepatitis B virus infection can cause polyarteritis nodosa.
  • Immune system diseases – Rheumatoid arthritis, lupus, and scleroderma can lead to vasculitis.
  • Allergic reactions – An allergic reaction to a medication can cause vasculitis.
  • Blood cell cancers – Leukemia and lymphoma can cause vasculitis.
  • Exposure to chemicals/drugs

What are the symptoms of vasculitis?

Symptoms of vasculitis vary according to which blood vessels and organ systems are affected. Symptoms that many people with vasculitis experience include:

  • Fever
  • Fatigue
  • Weight loss
  • Muscle and joint pain
  • Loss of appetite
  • Numbness in the extremities

How is vasculitis diagnosed?

To diagnose vasculitis, your doctor typically will begin by going through your medical history and conducting a thorough physical exam. Tests and procedures that may be used for diagnosing vasculitis include:

  • Blood tests – to determine your red blood cell count and to look for certain antibodies that might be attacking healthy cells.
  • Urine tests – to look for the presence of red blood cells and increased amounts of protein.
  • Non-invasive imaging, such as x-ray, ultrasound, computerized tomography (CT), and magnetic resonance imaging (MRI).
  • Angiogram (blood vessel x-ray) – A flexible catheter is inserted into a large artery or vein to examine its condition.
  • Biopsy – If another test suggests the presence of vasculitis, your physician may order a biopsy to establish a definitive diagnosis. A small sample of a blood vessel or an affected organ, such as the skin, kidney, lung or nerve, will be removed for testing.

How do we treat vasculitis?

Treatment for vasculitis depends on the severity of the illness and the organs involved. Vasculitis treatment options include the following medications:

  • Steroids – A corticosteroid drug, such as prednisone or methylprednisolone (Medrol), can be used to control inflammation for many types of vasculitis. Dosages are carefully monitored to minimize side effects.
  • Immunosuppressants are used to treat severe cases of vasculitis or those cases that don't respond well to steroid treatment. These drugs kill immune system cells that cause inflammation.

Request an Appointment

To learn more about our vasculitis services or to make an appointment with a Brigham and Women’s Hospital vasculitis specialist, please call 1-800-294-9999 or use our online appointment request form.