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Vasculitis symptoms

Symptoms of Vasculitis

These are some of the symptoms that you may experience if you have Vasculitis, but not necessarily all of them. It contains a large list of symptoms that cover all 15 diseases. Not all of these symptoms will pertain to you or your disease. These symptoms may often happen at different times and they can overlap

Symptoms can last for a long time or can come and go in a few weeks. Typically, symptoms appear, disappear, and then reappear. The times when a person is having symptoms are called flares. To help the doctor diagnose a form of Vasculitis and monitor its course, patients may want to keep a record of the symptoms that occur and when they occur. Because many conditions mimic Vasculitis, physicians must observe symptoms to make an accurate diagnosis

Dermatological symptoms

  • Erythema Nodosum — An eruption of red-purple swellings especially on the legs. It is most commonly found between the ages of 20 years and 50 years and affects women more often than men.
  • Papulopustules — Small, solid, slightly raised areas of the skin and areusually less than half an inch (1 cm) in diameter and may be round or flat, with a smooth or warty texture. They may be the color of surrounding skin or pigmented and usually contain pus. Pseudofolliculitis Acne that may or may not be indicative of actual infection within the body but most commonly the face or around hair follicles.
  • Purpura — Any of a group of disorders characterized by purplish or reddish brown area or spots of discoloration of the skin, ranging in size from pin-head to an inch or so in diameter, visible through the skin and caused by bleeding within underlying tissues with smaller bleeding points being sometimes called “petechiae” and larger darker ones being called bruises of “ecchymoses”.
  • Spider Nevus or Nevi, Splinter hemorrhages, Spider Veins,Telangiectasia — A discolored patch of skin that takes the form or a red, raised dot the size of a pin-head with small blood vessels radiating from this dot and represent the outward appearance of a dilated arteriole (small artery) and its connecting capillaries. They may be singular or multiple and adjoining.
  • Pyoderma Gangrenosum — Characterized by ulcers, usually on the legs, that turn into hard, painful areas surrounded by discolored skin.
  • Pathergy — Trauma to the skin which results in over-reaction of the skin and appearing as severe bruising being the result of an injury.
  • Mouth sores — Mouth sores (known as oral aphthosis and aphthous stomatitis) affect almost all patients with Behçet’s disease. They are often the first symptom that a person notices and may occur long before any other symptoms appear. The sores usually have a red border and several may appear at the same time. They can be painful and make eating difficult. Mouth sores go away in 10 to 14 days but often come back. Small sores usually heal without scarring, but larger ones may scar.

Nonspecific skin inflammatory reactivity to any scratches or intradermal saline injection is a common and specific manifestation of these lesions (pathergy test)

Joints and cartilage

Swelling and inflammation of the cartilage or connective tissues surrounding the bones and joints with knees a particular primary target, although this may occur in any joint of the body.

Joint Manifestations

Joint symptoms are the most frequently cited minor criterion. Although the prevalence of joint involvement varies among different populations, more than one-half of the patients develop signs or symptoms of synovitis, arthritis and/or arthralgia during the course of the disease.

Arthritis and arthralgias may occur in any pattern. In Vasculitis, arthritis may not be deforming, destructive or chronic, and may be the presenting symptom. A predilection exists for the lower extremities, and overall involvement of the large joints is predominant, with many cases being symmetric. Rare manifestations include aseptic necrosis, enthesopathies, and sacroiliitis. The latter can cause back pain.

The involvement of multiple joints is common. Clinical features are pain, tenderness, swelling, limitation of joint movement, warmth, and stiffness in the joints, especially the knees, ankles, wrists, and elbows.

Central Nervous System involvement

Central Nervous System

Vasculitis disease can affect the central nervous system. The central nervous system includes the brain and spinal cord and helps the body to coordinate movements and process information. Vasculitis can cause meningoencephalitis— inflammation of the brain and the thin membrane that covers and protects it. People with meningoencephalitis may have fever, headache, stiff neck, and difficulty coordinating movement, and should report any of these symptoms to their doctor immediately. If this condition is left untreated, a stroke can result.

  • Bacterial or Aseptic Meningitis. Inflammation of the meninges or membranes covering the brain and spinal cord and usually results from bacterial infection or inflammation by a variety of micro-organisms not ofa viral nature and is life-threatening and must have prompt and proper treatment.
  • Migraine Headaches. Severe headaches lasting from 2 hours to days of no specific number and is usually accompanied by vision disturbance and/or nausea with and without vomiting. Factors for these headaches may be stress related (anxiety, anger, worry, fear, excitement, depression, shock, over-exertion, routine changes, or climate changes), or food related (particularly dairy and cheese products, eggs, red wine, fried foods, citrus foods, or chocolate), or sensory related (bright light or glare, loud noises, and intense or penetrating smells). These headaches are generally of two types:
    • Common Migraine. Pain develops slowly and sometimes mounting to a throbbing pain and is often, but not always, on one side of the head only and usually occurs with nausea and sometimes vomiting.
    • Classical Migraine. Pain is preceded by a slowly expanding area of blindness surrounded by a sparkling edge that increases to involve up to 1/2 of the field of vision of each eye and lasts for about 20 minutes followed by a severe one-sided headache with nausea, vomiting, sensitivity of light, and other temporary neurological symptoms such as weakness in one half the body.
  • Papilledema. Optic Disk edema (swelling of the head of the optic nerve) caused by a rise in pressure within the brain.
  • Paresthesia. Altered sensations in the skin that causes numbness and tingling known as a “pins and needles sensation”.
  • Stroke. Damage to part of the brain caused by interruption to its blood supply by blockage of a vessel containing thrombus (blood-clot) or leakage of blood outside of vessel walls as that of a perforation of the blood vessel as is common of an aneurysm or ulceration of the blood vessel.
  • Memory Loss or Impairment. The loss of the ability to memorize and/or recall information stored in memory and which may be short-term duration of seconds or minutes only or long-term and lasting for days to permanent memory failure.
  • Hypertension, known as Benign Intracranial. Occurs when blood flow to and from the brain within the head is restricted causing too much pressure on the brain.
  • Depression. Feelings of sadness, hopelessness, pessimism, and a general loss of interest in life combined with a sense of reduced emotional well-being. Symptoms are usually shown in variable moods, loss of appetite, sleeping difficulty, loss of interest and pleasure in social activities, tiredness or fatigue, loss of concentration, movement either slowed or hyper as in anxious, agitated, or fidgety, suicidal thoughts, feelings of guilt or worthlessness, hallucinations or delusions (believing or envisioning something that is not real).
  • Psychosis. A mental disorder in which the individual loses contact with reality which disturbs the ability to think, perceive, and judge clearly such that sufferers often do not realize they are sick and may be identified as schizophrenia, manic-depressive, organic brain syndrome or paranoia.

Neurological Manifestations

The incidence of neurological involvement in Vasculitis varies according to the reports of different populations. The most severe manifestation of the disease, pathologic changes includes Vasculitis, perivascular white matter inflammation, and demyelinating lesions.

Neurological involvement may include meningoencephalitis (presents as headache and stiff neck), a multiple sclerosis-like illness, acute myelitis, stroke or pseudotumor cerebri. Focal neurological abnormalities also can be seen. Three categories of neurological involvement are:

  • brain stem syndrome,
  • meningomyelitic syndrome and
  • organic confusional syndrome.

Complicating the clinical picture is the occurrence of these different types in various combinations.

Neurological involvement is one of the most serious complications; it is thought to indicate a poor prognosis, with severe disability. Neurological manifestations may occur within 5 years of onset of the disease. Signs may include mental status changes and emotional labiality; seizures; clonus; positive Babinski sign; difficulty with speech or swallowing; and acute deafness.

The most frequent initial neurological symptom is severe headache, sometimes accompanied by stiffness in the neck. Other symptoms and signs can be:

  • unusual spells of confusion
  • instability
  • hallucinations and personality changes
  • spells of inability to focus or double vision
  • unusual difficulty in walking or balancing
  • incontinence
  • unusual dizziness or fainting
  • cranial nerve abnormalities (palsy)
  • pyramidal tract lesions with spastic paralysis; extra pyramidal, and cerebellar symptoms
  • dementia
  • numbness, pins and needles or weakness for no apparent reason.

While doctors maintain that peripheral nerve involvement is rare, many patients complain about this problem.

Gastro-intestinal and digestive tract

Digestive Tract

Only rarely does Vasculitis cause inflammation and ulceration (sores) in the digestive tract and lead to stomach pain, diarrhea, constipation, and vomiting. Because these symptoms are very similar to symptoms of other diseases of the digestive tract, such as a peptic ulcer, ulcerative colitis, and especially Crohn’s disease, careful evaluation is essential.

  • Mouth and Oral Ulcers. An Open sore caused by a break in the mucus membrane lining the mouth and may take the form of round or oval, shallow, grey, or yellow spots with an inflamed red border occurring singly on in clusters anywhere in the mouth or oral cavity. These may also take the appearance as aphthous ulcers (canker sores) or a close resemblance to that of the Herpes Simplex or cold sore.  They can appear singly or in crops, and are located anywhere in the oral cavity. The most common sites are the tongue, lips, buccal mucosa and gingiva. The tonsil, palate and pharynx are the less common sites. The ulcers can persist for one week or longer and subside without leaving scars. The interval between recurrences ranges from days to months.
  • Peptic Ulcers. A raw area that occurs in the gastrointestinal tract where it is bathed by acid gastric juice and usually occurs in the esophagus, stomach, or duodenum and may be singly or in several places with burning or gnawing pain in the abdomen of varying degrees of intensity, belching, bloated feeling, weight loss, nausea, and vomiting and on occasions bleeding with further intensified pain and evidences showing as red blood in the vomit and black streaks or spots in the feces. Chronic blood loss thru that means may result in iron-deficiency anemia. Intestinal perforation, an ulcerated hole, may cause severe inflammation and peritonitis in the abdominal cavity.
  • Ulcerated Colitis. Chronic inflammation and ulceration of the lining of the colon and rectum and usually appears as bloody diarrhea with feaces also containing pus and mucus accompanied by abdominal pain, tenderness, fever, and general malaise, and resulting anemia from the blood loss. Other symptoms include rashes, arthritis,  conjunctivitis or uveitis.

Gastrointestinal involvement of Vasculitis can be significant and sometimes life threatening, so it is vital to find and treat it urgently.

Optical and visual disturbances

The eyes may be affected in several different conditions such as Retinal Vasculitis, Iritis and Uveitis, Optic Atrophy and Trichiasis.

  • Retinal Vasculitis. Inflammation of the blood vessels in the eyes which causes visual disturbances which may or may not lead to permanent impairment.
  • Iritis. Inflammation of the iris within the eye.
  • Uveitis. Inflammation of the uvea, which may include the iris (Iritis), the ciliary body (Cyclitis), or the choroid (Choroiditis) and all of which may seriously affect vision.
  • Optic atrophy. The shrinking or wasting of the optic nerve fibers, which results in some or near total loss of vision.
  • Keratoconjunctivitis. Excessively dry eyes which is commonly seen in Sjogren’s syndrome, and which causes itching and burning of the eyes and creating the sensation of a foreign body under the eyelid.
  • Trichiasis or commonly called “Inverted Eyelashes” — A condition in which the eyelashes turn or grow inward toward the eyeball and may rub against the cornea causing corneal abrasion and jelly-like filled blisters in the corners of the eyes and occasionally extending to cover the entire white area in severe cases thus giving a very irritated and burning sensation in the eyes.

Genital ulceration

Appearing as vaginal and cervical ulcerations, epidydimitis or orchitis, haematuria or glomerulonephritis or proteinuria.

  • Vaginal and Cervical Ulcerations. Painful, sore, and sometimes fluid seeping skin or mucous membrane eruptions much like that of oral ulcerations occurring both externally on and around the vulva of a woman and internally on the vaginal walls and cervix and may present with appearance similar to that of Herpes Simplex Virus.
  • Epididymitis or Orchitis. Inflammation of the epididymis with fluid-filled cysts-like swellings appearing on the scrotum and penis, and, inflammation of the orchitis or testicles (a long coiled tube-connecting the vasa efferentia, which is the small tubes leading from the testicles, to the vas deferens which is the sperm duct leading to the urethra.
  • Cystitis or Haematuria. Cystitis is Inflammation of the inner lining of the bladder usually noted by intense burning and pain upon urination and a constant feeling of urgency to urinate. Haematuria is the red blood cells in the urine which may be readily visible or small amounts may give a smoky appearance and may enter the urine at any point along the urinary tract from the kidney to the urethral opening.
  • Protein urea and Glomerulonephritis. Protein urea is the passage of increased protein in the urine which usually results from damage to the glomeruli or filtering units in the kidneys. Glomerulonephritis is inflammation and damage to the glomeruli or filtering units of the kidneys which results in increased amounts of proteins and certain other body minerals such as potassium and calcium being excreted from the body in the urine and often resulting in deficiencies.

Fatigue

Fatigue is the constant feeling of extreme exhaustion. It is an inability to perform duties and tasks even after periods of resting, both short and long.  It may also be accompanied by malaise, a vague feeling of being sick or of physical discomfort and the need or desire to sleep.

Many Vasculitis patients feel extreme fatigue through out the course of the disease, with the feelings of sleepiness and lack of energy. They may need to take short naps or brief rests on a regular basis. They may also experience the inability to sleep due to pain and restlessness while still feeling exhausted.

Auditory disturbances

This may affect the ears with vertigo and Tinnitus resulting in hearing loss.

  • Vertigo. The illusion that one’s surroundings or self are spinning, either horizontally or vertically and is usually the result from a disturbance of the semicular canals in the inner ear or the nerve tracts leading from them.
  • Tinnitus. A Ringing, buzzing, whistling, hissing, or other noise heard in the ear in the absence of environmental noise and is almost always associated with hearing loss.

Bronchial disturbances

These can include asthma-like symptoms of Bronchospasms, homeostasis, embolus, pleurisy, and shadows on chest x-rays.

  • Bronchospasms. Mimicking asthma and allergic reactions of the lungs and seen as temporary narrowing of the bronchi (airways into the lungs) caused by contractions of the muscles in the lung walls, by inflammation of the lung linings or by a combination of both, which may also cause the release of substances during allergic reactions.  Other causes of these bronchospasms may include respiratory  infection, chronic lung disease (emphysema and bronchitis), or an allergic reaction to chemicals.
  • Heamoptesis. The medical term for coughing up blood it usually is a result of inflammation.
  • Embolus. Which is a clump of material that is present in the blood circulation; there it travels eventually to cause arterial obstruction.
  • Pleurisy. Inflammation on the pleura (membrane linings of the lungs and chest cavity) and usually the result of a lung infection which causes sharp chest pain that sometimes travels to the tip of the shoulder on the involved side and is worse when breathing in and and arises because the two inflamed membranes rub across each other.
  • Shadows on Chest x-rays appear as darkened areas usually indicating inflammation on or within lung tissues.

Inflamattion of blood wessels

Inflammation of the blood vessels and arteries that may occur anywhere in the body the blood travels and usually leads to damage of  the linings of those vessels and arteries with narrowing and restriction  or blockage of the blood flow resulting in tissue destruction and damage iin those areas affected by these vessels and arteries. Immune complexes consist of antigens (foreign materials such as components of microorganisms) bound to antibodies that have been formed in response to the antigens and are normally destroyed by phagotes (types of white blood cells), but sometimes settle in the walls of the blood vessels, where they cause severe inflammation.

  • Thrombophlebitis. Inflammation of part of a vein, usually near the surface of the body along with a clot formation in the affected segment and can occur as a result from a minor injury to a vein or develop as a complication of Varicose Veins or other blood vessel disorders such as Buerger’s Disease and characterized by obvious swelling and redness along the affected segment of the vein and most often accompanied by fever and malaise and is tender to the touch.
  • Varicose Veins. Twisted and distended veins beneath the skin and most frequently seen in the legs, although they can occur other locations throughout the body.
  • Buerger’s Disease, also called Thromboangitis Obliterans.  In which the arteries, nerves, and veins in the legs and occasionally the arms become severely inflamed thus narrowing the arteries blocking off blood supply to the toes and fingers eventually causing gangrene. The main symptom is pain in the hands and feet with victims suffering cold sensitivity and appearance of hands turning white, then blue, then red in cold conditions and which is also called Raynaud’s Disease.
  • Deep Vein Thrombosis. The clotting of blood within deep-lying veins, usually in the legs and thought to most often be the result of sluggish blood flow when a person lies or sits still for long periods of time. Clots in these veins may cause symptoms such as pain, tenderness, swelling, discoloration, and ulceration of the skin.
  • Aneurysm. Ballooning to an artery due to the pressure of blood flowing through a weakened area, frequently the result of inflammation in the surrounding artery area and often threatens and/or do rupture with very serious and severe consequences  and tissue damages.  The subclavian artery and pulmonary artery are most common arteries occluded. Depending on the site, arterial occlusions can have different clinical presentations. Pulseless disease is due to subclavian artery occlusion.
    • Deep venous thrombophlebitis has been described in patients, and superficial thrombophlebitis also occurred in patients. Symptoms correlate with the vessel involved and may be devastating. For example, Budd-Chiari syndrome is one that has been reported in patients, esophageal varices also have been described. Hypertension can originate from renal artery stenosis. Avascular necrosis of the femoral head is caused by femoral artery stenosis and intermittent claudication. Pulmonary vasculitis can produce dyspnea, chest pain, cough or hemoptysis.
    • Although less common than occlusion, aneurysm formation accounted for most vascular deaths. Common sites of aneurysms are abdominal aorta, femoral artery and thoracic artery.

Other manifestations

  • Hearing loss, tinnitus, dizziness and balance problems may occur.
  • Myocarditis and cardiac vessel disease may occur (including arrhythmias, pericarditis, vasculitis of the coronary arteries, endomyocardial fibrosis, and granulomas in the endocardium).
  • Major hemoptysis can be the result of pulmonary vascular thrombosis, aneurysms or vasculitis. Wheezing and breathlessness may point at pulmonary involvement.
  • Cases with renal involvement such as mild asymptomatic glomerulonephritis have also been reported. Some patients display recurrent urinary tract infections, although these may be in part due to immunosuppressive therapy. General swelling in all parts of the body (particularly face and limbs) with or without pain is common.

In general, you can expect to experience many more non- specific Vasculitis symptoms that are characteristic of other chronic diseases, such as chronic fatigue, not relieved by any amount of rest or sleep, depression, muscle pain and weakness.

These are just a sample list of symptoms and are non specific to each disease. It does not constitute for or take place of any kind of medical knowledge. Please consult your doctor if you experience any of these symptoms.