What’s Lupus Vasculitis?

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Lupus vasculitis is a complication of lupus where white blood cells attack blood vessels, causing inflammation and damage ranging from minor skin blemishes to severe organ damage. Diagnosis is through blood tests and treatment involves cortisone-based drugs and cytotoxic drugs in severe cases.

Lupus vasculitis is one of several complications that can result from the chronic inflammatory autoimmune disease known as lupus. Vasculitis occurs when white blood cells, which usually act beneficially in the body, actually attack both small and large blood vessels, causing inflammation. The damage caused by lupus vasculitis can range from minor skin blemishes to severe organ damage caused by destruction of the tissue around those organs. This condition is usually diagnosed through blood tests, although other procedures may be used depending on the areas affected. Treatment generally begins with cortisone-based drugs, which, in the most serious cases, are then strengthened by the addition of cytotoxic drugs.

Vasculitis generally results from a process that begins when antigens cause an allergic reaction in blood vessel walls. Antibodies are then created which bind to the antigen, thereby attracting white blood cells to the affected area to destroy the antigen. In this form of lupus, these white blood cells then build up in the blood vessel walls, causing the blood vessels to become inflamed.

The damage caused by this inflammation may be minor, such as when small blood vessels or capillaries break, causing red or purple dots on the skin that are usually painless. Depending on the severity of the inflammation and the location, the problems caused by lupus vasculitis can be much more serious. For example, inflammation can narrow the vessel walls, causing a reduction in blood flow to a particular area. It can also cause blood clots. The tissue surrounding the inflammation can die, which can lead to gangrene.

Serious problems can arise when vasculitis affects tissue near major organs. Vision loss due to tissue damage near the retina, pneumonia-like symptoms caused by vasculitis near the lungs, and even brain complications such as headaches, seizures, or strokes are all possibilities. Most commonly associated with this condition are joint problems, such as pain, swelling, or arthritis.

The diagnosis of lupus vasculitis usually comes from blood tests that determine the number of white and red blood cells or the presence of autoantibodies, which are created when antigens and antibodies bind together. Depending on the location of the problem, tests such as computed tomography (CT) scans or X-rays may be administered. Tissue samples via a biopsy can also definitively detect lupus vasculitis.

Treatment of this condition may not be necessary if the problem is limited to minor bleeding or red or purple spots caused by broken capillaries. More severe cases often require the prescription of cortisone-based medications known as corticosteroids. If they do not limit the effects of the condition, cytotoxic drugs are the next step in combating vasculitis. These drugs are usually given in tandem with corticosteroids.

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