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Giant Cell Arteritis     return to Vasculitis main page
Affects the main arteries and can be divided into 2 large groups.
Temporal arteritis is a type of systemic arteritis of the large and medium-sized arteries and occurs mainly in older people. The head arteries are commonly inflamed, occasionally causing sudden blindness. Other arteries throughout the body may exceptionally be affected, leading to insufficient oxygenated blood supply to the limbs and/or internal organs.
In Takayasu arteritis, the large and medium-sized arteries are inflamed and become narrower, often involving the aortic arch and its branches. Patients tend to be young females. The cause is infections..


Thromboangiitis obliterans or Buerger's Disease
Type of vasculitis that may affect, narrow and eventually obstruct the medium-sized and small arteries and veins, mainly in the hands and feet. There is a clear association with tobacco use. Hence, giving up smoking is the only treatment and is mostly effective.
Behçet's disease
Classic symptoms are episodes of aphthous oral ulcers, genital ulcers as well as recurrent eye inflammation (uveitis). The underlying cause is a vasculitis that affects mainly the small veins. Behçet's disease, however, may occur in all types of organs because of its ability to affect blood vessels of nearly all sizes and types.
Erythema nodosum
Characterised by returning groups of painful red nodular (knob-like) subcutaneous lesions at the level of the lower legs, sometimes also located elsewhere. In 50 % of the patients no cause is found and lesions disappear spontaneously. In others, an underlying cause is found. The cause may be tuberculosis, a streptococcus infection or other infections, infections of the intestines, sarcoidosis, Behçet's disease.
Treatment
Systemic vasculitis requires in most cases intensive treatment with  antibiotics , we have used Vibramycine 100mg twice a day for three weeks to stop Takayasu completely  in many patients.

Corticosteroids, sometimes combined with immunosuppressive drugs like azathioprine (Imuran) or cyclofosfamide (Endoxan). Treatment has to be individualised according to the extent, seriousness and evolution of the involved organs.

 

Vasculitis means inflammation of the blood vessel ( within the walls of the vessel).
Blood vessels  (arteries) transport oxygen and nutritional substances from the heart to the body tissue and (veins) return the blood back to the heart.
The right side of the heart circulation pumps the blood to the lungs. In the lung small blood vessels called capillaries where  the blood is saturated with oxygen, after which it returns to the heart.
Blood vessels that carry the blood away from the heart are called arteries. Blood vessels that return the blood to the heart are called veins.
Starting from the heart, blood vessels can be divided in large arteries, medium-sized and small arteries, arterioles, capillaries, small and large veins.
The type of vasculitis depends on the type of blood vessel affected,  the cause of the inflammation is mostly autoimmune.
It is impossible to describe all types of vasculitis, but to be complete, we refer to a classic subdivision of Cupps and Fauci (National Institute of Health, USA).

Please continue see more on Vasculitis

 


 

Dr. M. Walravens, rrheumatologist, O.L. Vrouw-Clinic, Aalst
 

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