Vasculitis: Clinical

Vasculitides are a group of disorders that cause vasculitis, which is inflammation in the walls of the blood vessels.

Since blood vessels pass through organs - vasculitis damages those organs, and mimics a variety of diseases.

There are usually systemic symptoms like fever, fatigue, joint pain, and weight loss; as well as organ-specific symptoms that may literally involve any organ.

Whenever vasculitis is suspected, there’s inflammation, which is often reflected by an increased ESR, CRP, and increased white blood cell count, and sometimes requires a biopsy of whichever organ or tissue is involved.

The vasculitides are divided into groups based on the size of the arteries that are mainly involved.

There’s large vessel, medium vessel, and small vessel vasculitis which affects small arteries and capillaries.

Starting with large vessel vasculitis, the first condition is Giant cell arteritis, also called temporal arteritis.

This is the most common vasculitis in individuals over the age of 50.

The most frequently affected arteries are the external carotid, ophthalmic, and temporal arteries.

Symptoms include a headache and vision loss, and a worrisome complication is that there’s a high risk for a stroke.

Often, the temporal artery can become tender and rigid.

In addition, individuals can get jaw claudication, which is when there’s temporal artery insufficiency causing ischemia of the masticatory muscles, leading to pain while chewing.

Diagnosis of giant cell arteritis is done with temporal artery biopsy, looking for giant cells in the tissue.

The next large vessel vasculitis is Takayasu arteritis.

This is an extremely rare condition affecting mostly young women, generally younger than 40 years old, with increased incidence in the Asian populations.

Takayasu arteritis primarily affects the aorta and its major branches.

And the inflammation can cause turbulent blood flow which results in vascular bruits on auscultation of any involved artery - the aorta, carotid, renal, or femoral artery.