Autoimmune

Vasculitis: Complete Guide

Vasculitis refers to a group of conditions causing blood vessel inflammation, which can affect virtually any organ depending on which vessels are involved.

Types
Large, medium, small vessel vasculitis
Most common type
Giant cell arteritis (large vessel)
Key test
ESR/CRP, ANCA, biopsy
Treatment
Steroids ± immunosuppressants

Classification by Vessel Size

CategoryExamplesKey Features
Large vesselGiant cell arteritis, Takayasu arteritisHeadache, jaw claudication, visual loss (GCA)
Medium vesselPolyarteritis nodosa, Kawasaki diseaseOrgan-specific symptoms depending on vessels affected
Small vessel (ANCA-associated)GPA (Wegener's), microscopic polyangiitisKidney involvement, lung symptoms, skin rash

Giant Cell Arteritis — The Most Common Type

GCA typically affects people over 50, causing new headache, scalp tenderness, jaw pain when chewing, and — critically — risk of sudden permanent vision loss if untreated. It's closely associated with polymyalgia rheumatica and requires urgent high-dose steroid treatment when suspected.

Key Investigations

TestPurpose
ESR/CRPUsually significantly elevated
ANCA (antibodies)Positive in small vessel vasculitis (GPA, microscopic polyangiitis)
Temporal artery biopsyConfirms GCA diagnosis
UrinalysisScreens for kidney involvement in ANCA-associated vasculitis
Imaging (CT/MRI/PET)Assesses large vessel involvement
GCA Visual Symptoms — EmergencyAny visual disturbance in someone with suspected giant cell arteritis requires immediate high-dose steroid treatment and same-day ophthalmology/rheumatology assessment — untreated, vision loss can become permanent within hours.
Steroids Started Before Biopsy ConfirmationIn suspected GCA, high-dose steroids are started immediately based on clinical suspicion, without waiting for biopsy confirmation — the biopsy can still show characteristic changes for up to 2 weeks after starting treatment, but vision protection takes priority.
Is vasculitis a form of arthritis?
No — vasculitis specifically involves blood vessel inflammation, which can occur alongside joint symptoms in some types, but is a distinct group of conditions from arthritis (joint inflammation) itself.
Can vasculitis be cured?
Some forms achieve long-term remission with treatment, though relapses can occur — treatment typically involves an initial intensive phase (often steroids ± other immunosuppressants) followed by a maintenance phase.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.