Vasculitis Symptoms and Immune Disorders

Identifying skin spots, fever, and muscle aches.

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Vasculitis: Symptoms and Risk Factors

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Vasculitis can cause many different symptoms because it can affect any blood vessel in any organ. The symptoms depend on which organ is affected by reduced blood flow. Still, many types share general symptoms, called constitutional symptoms, that show the body is inflamed. Vasculitis is sometimes called a great imitator because it can look like other diseases. Noticing both general signs of inflammation and specific organ problems is important for spotting the condition.

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Constitutional Symptoms

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General Signs of Inflammation

Almost all patients with systemic vasculitis experience non-specific symptoms that indicate the body is fighting inflammation.

  • Fever: Unexplained high temperatures are common.
  • Fatigue: Profound tiredness that does not improve with rest is a hallmark.
  • Weight Loss: Unintentional weight loss occurs frequently.
  • Myalgia and Arthralgia: Generalized muscle aches and joint pains without obvious swelling are early indicators.

Onset and Progression

These symptoms can develop suddenly or gradually over months. In acute cases, the patient may present with a rapid decline in health, while chronic forms may present as a lingering illness that is difficult to diagnose.

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Skin Manifestations

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The skin is one of the most commonly affected organs and often provides the first visible clue to the diagnosis.

  • Palpable Purpura: These are raised, reddish-purple spots usually found on the legs. They do not blanch or turn white when pressed, indicating bleeding into the skin.
  • Livedo Reticularis: A lace-like, purple discoloration of the skin caused by swelling of venules.
  • Ulcers: Painful open sores, often around the ankles, caused by a lack of blood flow to the skin tissue.
  • Nodules: Tender lumps under the skin.
  • Digital Gangrene: In severe cases, the tips of fingers or toes may turn black and die due to complete blockage of the blood supply.

Respiratory and ENT Symptoms

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The respiratory tract is a major target for ANCA-associated vasculitis.

  • Sinusitis: Chronic sinus infections, crusting, and bloody discharge from the nose are classic signs of Granulomatosis with Polyangiitis.
  • Saddle Nose Deformity: Collapse of the nasal bridge due to cartilage destruction.
  • Cough and Hemoptysis: Inflammation in the lungs can cause coughing, shortness of breath, and coughing up blood.
  • Asthma: Adult-onset asthma is a key feature of Eosinophilic Granulomatosis with Polyangiitis.
  • Lung Nodules: Imaging may reveal nodules or cavities in the lung tissue.

Renal Involvement

The kidneys are frequently involved in small vessel vasculitis, often without causing pain.

  • Glomerulonephritis: Inflammation of the filtering units of the kidney.
  • Hematuria: Blood in the urine, which may be microscopic.
  • Proteinuria: Excess protein in the urine, causing it to look foamy.
  • Hypertension: New or worsening high blood pressure.
  • Renal Failure: If untreated, the damage can progress rapidly to kidney failure requiring dialysis.

Neurological Symptoms

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Vasculitis can affect both the central and peripheral nervous systems.

  • Mononeuritis Multiplex: This is a distinctive feature where individual nerves are damaged sequentially. It often presents as foot drop (inability to lift the front part of the foot) or wrist drop.
  • Peripheral Neuropathy: Numbness, tingling, burning, or weakness in the hands and feet.
  • Headaches: Severe headaches, scalp tenderness, and jaw pain while chewing are classic symptoms of Giant Cell Arteritis.
  • Stroke: Inflammation of brain arteries can lead to strokes or transient ischemic attacks.
  • Vision Loss: Sudden, painless loss of vision in one eye can occur in Giant Cell Arteritis and is a medical emergency.

Cardiovascular and Gastrointestinal Symptoms

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  • Heart: Inflammation can affect the coronary arteries (causing angina or heart attacks), the heart muscle (myocarditis), or the lining around the heart (pericarditis).
  • Abdomen: Abdominal pain, particularly after eating (intestinal angina), nausea, vomiting, and blood in the stool can indicate vasculitis of the mesenteric arteries. Severe cases can lead to bowel perforation.

Risk Factors

  • While the exact cause is often unknown, several factors increase the likelihood of developing vasculitis.

    • Age: Giant Cell Arteritis specifically affects people over 50, while Kawasaki disease affects young children.
    • Ethnicity: Behcet’s disease is more common in people from the Middle East and Asia.
    • Genetics: Certain genetic markers (HLA types) are associated with specific forms of vasculitis.
    • Smoking: Smoking is a strong risk factor for Buerger’s disease, which affects blood vessels in the limbs.
    • Infections: Chronic Hepatitis B or C infection is a major risk factor for Polyarteritis Nodosa and Cryoglobulinemia.
    • Autoimmune History: Having another autoimmune condition, like Lupus or Scleroderma, increases risk.
    • Medications: Certain drugs, including hydralazine and propylthiouracil, can trigger ANCA-associated vasculitis.

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FREQUENTLY ASKED QUESTIONS

What is the most common symptom of vasculitis?

A urologist is a surgeon trained to treat conditions of the urinary tract in both men and women. A urogynecologist has specific training in female pelvic medicine and reconstructive surgery, focusing on conditions like bladder prolapse and female incontinence.

The bladder lining (urothelium) has a high regenerative capacity and heals quickly after minor trauma or infection. However, the muscle layer (detrusor) does not regenerate well. If the muscle is damaged by chronic overdistention or fibrosis, the loss of function is often permanent.

Yes, psychological stress can exacerbate bladder symptoms. The bladder has many nerve receptors sensitive to stress hormones. “Stress incontinence” refers to physical pressure (coughing/sneezing), but anxiety can trigger “urgency” and frequency, mimicking Overactive Bladder symptoms.

Yes, the bladder’s functional capacity tends to decrease with age. Furthermore, the elasticity of the bladder wall reduces, and the kidneys produce more urine at night (nocturnal polyuria), leading to increased nighttime urination in older adults.

 Neurogenic bladder is a term used when the nerve control of the bladder is disrupted due to a brain, spinal cord, or nerve condition (like diabetes or MS). This can cause the bladder to either be unable to hold urine (incontinence) or unable to empty it (retention).

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