Lupus Site - a guide for lupus patients and their families

Vasculitis is an inflammation of the blood vessels. It can affect capillaries, arterioles, venules, arteries & veins.

If a small blood vessel (capillary) is inflamed, it can break, which leads to bleeding in the tissue, which appears as small red/purple dots on the skin. If a large blood vessel (artery or vein) is inflamed, a nodule may be produced, & the inside of the vessel can become narrow, which means that not as much blood can flow through the vessel. A blood clot may form inside the vessel, blocking it. If this happens, no blood can get to the tissues & they can start to die, this can lead to gangrene.

Vasculitis can be caused by an infection of the blood vessel walls, or an immune reaction in the vessel walls.

Vasculitis can cause different symptoms, depending on which part of the body is involved. The symptoms can vary from very mild to causing major organ damage.

The symptoms include - muscle & joint pain, fatigue, malaise, fever, weight loss. Red/purple dots (known as petechiae) can develop on the skin, larger spots are known as purpura. Other skin symptoms include - hives, lumpy rashes, gangrene of fingers & toes, ulcers. Vasculitis in the brain can cause seizures, strokes, headaches & confusion. It can affect the peripheral nerves, causing numbness & tingling, & loss of sensation. Vasculitis in the heart & kidneys is uncommon in lupus patients. In the lungs it can cause attacks which are like pneumonia, which can lead to scarring of the lung tissue. Blurred vision can be an indication of vasculitis in the small blood vessels in the retina.

Vasculitis can be diagnosed using blood tests, abnormalities which normally show up are a high white blood cell count, high platelet count & an elevated sedimentation rate (ESR). Tests specific to the part of the body involved may also be used, e.g. EKG & echocardiogram for heart involvement, chest x-ray for lung involvement.

Mild cases of vasculitis (confined to the skin) do not usually need treatment. Severe cases can be treated with corticosteroids and cytotoxic drugs (azathioprine & cyclophosphamide)