Vasuliitin

Vasuliitin is the term used to describe a group of disorders characterized by inflammation of the blood vessels. This inflammation can involve arteries, veins, or capillaries and may lead to wall damage, narrowing, occlusion, or aneurysm formation. Vasuliitin is not a single disease but a spectrum, with various subtypes that differ in clinical presentation, affected vessels, and prognosis.

Vasuliitin is commonly classified by the size of the affected vessels. Large-vessel vasuliitin includes conditions such as giant cell arteritis and Takayasu arteritis. Medium-vessel vasuliitin includes diseases like polyarteritis nodosa and Kawasaki disease (primarily in children). Small-vessel vasuliitin encompasses several conditions, such as granulomatosis with polyangiitis, microscopic polyangiitis, and IgA vasuliitin. Some subtypes may predominantly affect the kidneys, skin, nerves, or lungs, while others cause widespread systemic symptoms.

Clinical features vary by subtype and organ involvement but often include fever, fatigue, weight loss, and malaise. Specific symptoms may involve headaches and visual disturbances in large-vessel disease, skin rashes or purpura in small-vessel disease, renal impairment, neuropathy, or pulmonary symptoms depending on the vessels affected.

Diagnosis relies on a combination of clinical assessment, laboratory tests (including markers of inflammation like ESR and CRP, and, where appropriate, ANCA testing), imaging studies (such as ultrasound, CT or MR angiography, PET-CT), and tissue biopsy when feasible. Treatment typically starts with corticosteroids to control inflammation, often supplemented by immunosuppressants or targeted biologic therapies depending on the subtype and severity. Prognosis varies widely, influenced by the specific vasuliitin form, organ involvement, and response to treatment.