What is Vasculitis?

11-36% of SLE patients suffer from lupus vasculitis, a condition where inflammation damages blood vessels throughout the body. It drains your energy, causes painful skin lesions, and can damage vital organs. This article will explore what lupus vasculitis is, what causes it, its symptoms, how it’s diagnosed, and how it can be treated.

*Disclaimer:

The information provided in this article is for general informational purposes only and is not intended as medical advice. It should not be used as a substitute for professional diagnosis, treatment, or advice from a qualified healthcare provider. Reliance on any information provided in this article is solely at your own risk.

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Vasculitis is an inflammation of the blood vessels. When you have lupus, your immune system can mistakenly attack the walls of your blood vessels, which in turn causes them to become inflamed.

This inflammation can cause blood vessels to:

• Become blocked: restricting blood flow to organs and tissues

• Weaken: making them more prone to bleeding

• Thicken: which affects how well they are able to function

Lupus vasculitis can affect blood vessels of any size, from small capillaries in your skin to even larger arteries that are responsible for supplying your lungs or brain. The severity of it varies, so some people might only have skin symptoms while others could have organ shutdowns.

Many factors can trigger lupus or worsen it:

• Lupus flares, which are periods when your lupus activity increases

• Antibodies/antigens accumulate in blood vessel walls

• A family history of autoimmune diseases

• Environmental factors such as UV exposure, stress, and certain medications

The exact reason why some people develop lupus vasculitis and others don’t isn’t fully understood, but it is known to be somewhat linked to overall lupus activity.

• Purpura: Purple or red spots found on the legs, hands, and feet, that don’t disappear when pressed

• Ulcers: Painful open sores that are slow to heal, found especially on the legs

• Livedo reticularis: A net like red or purple pattern

• Hives: Itchy, red bumps

• Nail fold infarcts: Dark lines underneath your fingernails

• Nodules: Bumps under the skin

Reach out to a healthcare provider when:

• You gain new skin lesions or ulcers that won’t heal

• You notice numbness or tingling that’s getting worse

• You experience severe headaches, confusion, or vision changes

• You start seeing blood in your urine

• The previously mentioned symptoms are keeping you from doing things you normally enjoy

• Physical examination: Your doctor will take a look at your skin for other signs of vasculitis

• Blood tests: Checks for inflammation markers (ESR, CRP), antibodies, and organ function

• Urinalysis: Looks for protein or blood in urine (kidney function)

• Skin biopsy: A small piece of affected skin is looked at under a microscope

• Imaging tests: CT scans, MRIs, or angiography might be used if organs appear to be affected

• Nerve conduction studies: If peripheral neuropathy is present (numbness in hands and feet)

• Corticosteroids: Usually the first line treatment to quickly reduce inflammation (prednisone, methylprednisolone)

• Immunosuppressants: Medications to suppress the overactive immune system (azathiprine, cyclophosphamide)

• Biologics: For severe cases (rituximab, belimumab)

• Antimalarials: To help control overall lupus activity and reduce flare up risk (hydroxychloroquine)

• Sun protection: Wear sunscreen SPF 30 or higher and protective clothing, since UV exposure can trigger lupus flares

• Quitting smoking: Smoking worsens blood vessel damage and healing time

• Healthy diet: Try to eat anti inflammatory foods like fruits, vegetables, omega 3 fatty acids and whole grains

• Regular exercise: Walking or stretching can improve circulation, but make sure to balance it with rest

• Stress management: Practice meditation or breathing exercises

• Pacing yourself: Break up tasks throughout the day and make sure to rest when you body needs it.

While vasculitis is a serious complication of lupus, with the proper diagnosis and treatment, inflammation can be combatted and your organs can be properly protected. If you notice new or worsening symptoms, don’t hesitate to reach out to your healthcare provider as soon as possible.

Types of Vasculitis | Johns Hopkins Vasculitis Center

Vasculitis and Lupus | Lupus Foundation of America

Vasculitis | Mayo Clinic

Vasculitis | American College of Rheumatology