Vasculitis

Diagnosis

Diagnosis starts with a medical history and a physical exam. You may have one or more tests and procedures. These can either diagnose vasculitis or rule out other conditions that cause some of the same symptoms. Tests and procedures might include:

• Blood tests. These tests look for signs of inflammation, such as a high level of C-reactive protein. A complete blood cell count can tell whether you have enough red blood cells. Other blood tests, such as the antineutrophil cytoplasmic antibody (ANCA) test, can look for certain antibodies. These tests can help diagnose vasculitis.
• Imaging tests. Imaging tests can show which blood vessels and organs are affected. They also can help your healthcare professional know how you respond to treatment. Imaging tests for vasculitis include X-rays, ultrasounds, CT scans, MRIs and positron emission tomography (PET) scans.
• X-rays of your blood vessels. During this procedure, called angiography, a flexible catheter resembling a thin straw goes into a large artery or vein. A special dye goes into the catheter. You have X-rays taken as the dye fills the artery or vein. The X-rays show the outlines of your blood vessels.
• Biopsy. This is a surgery in which a healthcare professional removes a small sample of tissue from the affected area of your body. Your health professional then looks at the tissue for signs of vasculitis.

Treatment

Treatment aims to control the swelling and irritation, called inflammation. It also aims to manage the conditions that may be causing the vasculitis.

Most types of vasculitis can come back. This is called a flare. So your healthcare professional may need to follow you a long time after your symptoms go away.

Medications

A corticosteroid medicine, such as prednisone (Rayos), is the most common type of medicine prescribed to control the inflammation of vasculitis.

Corticosteroids can have bad side effects. The longer you take them, the worse the side effects may be. Side effects may include weight gain, diabetes and weakened bones. If you need a corticosteroid long-term, you get the lowest dose that will help.

Your healthcare professional may add other medicines to corticosteroids to control the inflammation. That way, you can lower the dose of corticosteroids more quickly. The medicine used depends on the type of vasculitis. Medicines may include methotrexate (Trexall), azathioprine (Imuran, Azasan), mycophenolate mofetil (CellCept), cyclophosphamide (Cytoxan), tocilizumab (Actemra) or rituximab (Rituxan).

Which medicines you need depend on the type of vasculitis you have, how bad it is, which organs are involved and any other medical problems that you have.

Surgery

Sometimes, vasculitis causes a balloonlike bulge in the wall of a blood vessel. This is called an aneurysm. This bulge may need treatment with surgery to lower the risk of it breaking. Blocked arteries also may need surgical treatment to restore blood flow to the affected area.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Coping and support

Coping with the side effects of the medicines you take to treat your vasculitis might be one of the hardest things about living with the condition. Some of these tips might help:

• Know about your condition. Learn all you can about vasculitis and its treatment. Know the possible side effects of the medicines you take. Tell your healthcare professional about any changes in your health.
• Follow your treatment plan. Your plan may include seeing your health professional often, having more tests and checking your blood pressure.
• Eat well. Eating healthy foods can help prevent some of the problems your medicines can cause. This might include thinning bones, high blood pressure and diabetes. Eat mainly fresh fruits and vegetables, whole grains, low-fat dairy products, and lean meats and fish. If you're taking a corticosteroid medicine, ask your healthcare professional if you need to take a vitamin D or calcium supplement.
• Get vaccinations. Some medicines to treat vasculitis raise your risk of infections. These include flu, pneumonia, shingles and COVID-19. Keeping up to date on vaccinations can help. Talk with your healthcare professional about which vaccinations to get.

• Exercise most days of the week. Regular aerobic exercise, such as walking, can help prevent conditions that can be linked to taking corticosteroids. These include bone loss, high blood pressure and diabetes. Regular exercise also helps your heart and lungs.

  Many people also find that exercise improves their mood and sense of well-being. If you're not used to exercising, start out and build up slowly. Your healthcare professional can help you plan an exercise program that's right for you.

• Ask others to help. Family and friends can help you cope with this condition. You also might find it helpful to talk with others who have vasculitis. Ask a member of your healthcare team about support groups.

Preparing for your appointment

Make an appointment with your main healthcare professional if you have symptoms that worry you. For vasculitis, you may need to see specialists. They might include:

• Rheumatologists, who specialize in joints, muscles and autoimmune diseases.
• Neurologists, who specialize in the brain and nervous system.
• Ophthalmologists, who specialize in the eyes.
• Cardiologists, who specialize in the heart.
• Nephrologists, who specialize in the kidneys.
• Pulmonologists, who specialize in the lungs.
• Dermatologists, who specialize in the skin.
• Urologists, who specialize in the urinary tract and urogenital systems.
• Otorhinolaryngologists, who specialize in the ears and sinuses.

What you can do

To prepare for your appointment:

• Be aware of anything you need to do before your appointment. When you make the appointment, ask if you need to do anything in advance, such as restrict your diet.
• Send test information. If you go to a specialist, ask your main healthcare professional to send your imaging and biopsy results before the appointment.
• List all your symptoms, and when they began.
• List key personal medical information. Include other recent health issues or major stresses you've had. List all medicines, vitamins and supplements you take, including doses.
• Ask a family member or friend to go with you. Someone who goes with you can help remember the information you get.
• List questions you want to ask your healthcare team.

For vasculitis, some basic questions to ask include:

• What type of vasculitis do I have?
• What's causing my vasculitis?
• Will my vasculitis go away on its own or is there a cure?
• Should I see a specialist?
• What are my treatment choices?
• I have another medical condition. How can I best manage these conditions together?
• Do you have brochures or other printed material that I can have? What websites do you suggest?

What to expect from your doctor

Your healthcare professional may ask:

• Do your symptoms stay with you or do they come and go?
• How bad are your symptoms?
• What, if anything, seems to make your symptoms better?
• What, if anything, seems to make your symptoms worse?