Vasculitis is a designation for a group of rare diseases that cause inflammation of blood vessels. These vessels can be microscopic or even arteries and veins. There are different types of vasculitis, and they can vary greatly in symptoms, severity, and duration.
The disease occurs when immune cells invade the wall of blood vessels — causing bleeding, occlusion or stricture. The condition can be caused by autoimmune diseases, allergic reactions, overuse of medications, or viral infections.
“Syphilis itself or Lyme disease, which affected Justin Bieber, can also cause inflammation of these vessels,” he explained to the CNN André Ramos, rheumatologist at BP – The Portuguese Beneficence of São Paulo.
In the case of these diseases, the doctor explains that environmental and genetic factors can also increase the risk of emergence.
On Monday (8), actor Ashton Kutcher, 44, spoke for the first time about the diagnosis of the disease he received about two years ago.
“Two years ago I had this weird, super rare form of vasculitis that, like, ruined my eyesight, my hearing, my balance,” the actor told Bear Grylls, in a preview of the adventure show “Running Wild”.
In this exclusive look at an upcoming episode of @natgeotv‘s #RunningWild with @BearGrylls: The Challenge, #Ashton Kutcher opens up about a rare medical disorder that left him without the ability to hear, see or walk. pic.twitter.com/diG6xR1WPp
— Access Hollywood (@accesshollywood) August 8, 2022
Most types of vasculitis are rare and the causes are usually not known, according to the American College of Rheumatology.
“In the case of the actor, there is no way to be sure what could have caused the illness. But, for example, Cogan syndrome is a super rare vaculitis that has rheumatologic manifestations and that can affect vision and hearing,” said Ramos.
Vasculitides can be classified as primary or secondary, the first being rare diseases of little known causes, and occurring when the blood vessel is the main target of the disease, and the secondary ones are those in which the vessels are affected, but this involvement is associated with some other condition that may be causally related to tissue inflammation.
“The classification of vaculitis is according to the size of the vessels. When there is involvement of microvessels, it is a vasculitis of small vessels. On the other hand, when there are larger vessels, such as the aorta, or branches of the aorta, we call them great vessels,” explained Ramos.
The condition affects people of both sexes and of all ages. Some forms of vasculitis affect certain groups of people. For example, Kawasaki disease only occurs in children up to five years old.
IgA immunoglobulin (Henoch-Schönlein) vasculitis is much more common in children than adults. Giant cell arteritis only occurs in adults over 50 years of age.
Diagnosis of vaculitis
The symptoms of the disease can be very very varied, in this sense, professionals suspect vasculitis when a patient has signs and abnormal results of the physical examination, laboratory tests or both, and there is no other clear cause.
In general, the most common symptoms are fever, tiredness and arthralgia. Patients may also present symptoms that will vary according to the organ (and type of vessel) affected.
“The fact that a manifestation affects the auditory system is very characteristic of a type of vasculitis. Some manifestations are more specific and help us to make the diagnosis”, said Ramos.
The doctor also points out that other vasculitis present as a skin lesion and there may be a biopsy, in other cases, laboratory and imaging tests are necessary.
“Sometimes there are vaculitis that affect the lung and the blood test is very characteristic [para detectar]said.
For diagnosis, the most common tests are:
- Biopsy: surgical removal of a small piece of tissue for inspection under a microscope;
- Angiography: a type of X-ray to look for blood vessel abnormalities
- Blood and laboratory tests.
treatments
According to the American College of Rheumatology, treatment for most vasculitis may involve steroids — drugs that help reduce inflammation but can have long-term side effects.
Doctors sometimes prescribe immunosuppressive drugs because their long-term side effects may be less severe than those of steroids. This is called a “steroid-sparing” treatment.
“As we do not have a single defined cause, it is not possible to say that there is a cure. But, in most rheumatic diseases, we have a very important arsenal of treatments in which most involve immunosuppression, that is, reducing the inflammatory process”, explained Ramos.
For less severe vasculitides, patients may be given methotrexate, azathioprine, or other immunosuppressive drugs. Usually these drugs are used to treat other rheumatic diseases, but they are also useful for vasculitis.
In this case, the doctor explained, immunity is more “regulated so that the disease remains in remission”.
“Often the remission is sustained over time and the patient can go without medication, this would not necessarily be a cure, but it would be ‘practically’ a cure, because you would not need to do anything specific to control the disease,” he said.
Source: CNN Brasil
