Detailed characteristics of vasculitis, forms and types of the disease. Vasculitis - what is this disease? Symptoms, causes and treatment Articular vasculitis symptoms

Often, patients who are diagnosed with hemorrhagic vasculitis turn to doctors. It is accompanied by a variety of clinical picture and can lead to various unpleasant consequences. The disease can appear regardless of age, but children under three very rarely get it. The pathology mainly occurs in children aged 4-12 years. IN this disease will be discussed in this article.

Hemorrhagic vasculitis: what kind of disease is it, photo

What is it Vasculitis, photo, symptoms, treatment this disease? Hemorrhagic vasculitis is a pathology that affects the capillaries of the skin, joints, gastrointestinal tract and kidneys. Therapy for this disease is carried out comprehensively. How to treat the disease?

Which are presented below, is carried out under the supervision of a doctor. He prescribes medications, physiotherapeutic procedures, massage, hydrotherapy, and physical therapy.

Treatment for adults and children is practically the same. Throughout the course of the disease, a specialist may recommend different procedures, change the treatment plan, taking into account the patient’s condition.

Vasculitis: symptoms and causes

Before you figure out what it is Vasculitis, photo, symptoms, treatment of this disease, one should understand what are the causes of this pathology? No doctor can say exactly what was the result of vasculitis, since the reasons have not been precisely established. Experts attribute this disease to several factors. So, a person who has had:

• infectious pathologies, especially if these were acute or chronic inflammatory processes developing in the upper respiratory tract, or measles, chicken pox, streptococcal diseases;
• injuries and other damage to the skin and blood vessels;
• damage from a high dose of solar radiation, radiation;
• allergies to medical supplies, food, insect bites;
• intoxication;
• helminthic infestations;
• changes in the body due to the development of neoplasms that have a malignant or benign course;
• changes in female body during pregnancy;
• disruptions in the metabolic process in the event of the development of endocrine pathologies;
• heredity.

If hemorrhagic vasculitis occurs in adults, it is most often in old age, when the defense mechanism immunity.

The symptoms of this disease occur unexpectedly; no preliminary signs are observed. Gradually, the manifestations begin to be expressed more clearly. In most cases, the patient's body temperature rises and worsens general state, weakness and headaches occur. These symptoms are considered signs of intoxication. But it is impossible to make a diagnosis with them, since many diseases occur this way.

The most pronounced symptom is . It can be localized on the feet, buttocks, legs, and rarely on the stomach, arms, and back. , palms, neck does not appear at all, which the doctor takes into account in the differential examination method.

Rashes can appear in different forms:

• small blisters with a red tint;
• papules that become pale when pressed;
• reddish papules located on the mucous membrane of the mouth and pharynx;
• nodules with a purple color;
• small bruises.

In diameter and other parts of the body it can reach 1 cm. Manifestations last up to 4 days, after which they become pale and gradually disappear altogether. After a week, the patient can expect a recurrence of the rash.

In the most early stage pathology, it looks like a small one, which is located on the legs and upper area of ​​​​the feet.

Together with skin manifestations, patients are worried about severe itching, swelling of the lips, eyelids, perineum. When palpated, the rash causes pain. After it disappears, pigment spots remain on the body, which peel off during a relapse.

Symptoms of hemorrhagic vasculitis also include damage to internal organs and joints. The patient may experience pain during physical activity, swelling, and redness of the body. There is no disruption of the joint structure, but pain syndrome may last for several hours.

There are also disruptions in the activity of the gastrointestinal tract, which manifest themselves in the form of cramping painful sensations in the abdomen, nausea and vomiting, blood discharge in the stool resulting from bleeding from the intestinal mucosa.

If therapy for the disease is not carried out on time, the pathology can cause severe vomiting, loose, bloody stools caused by bleeding in the stomach or intestines. Blood discharge is not particularly dangerous; it occurs in almost half of patients.

Among other things, there is an anemic disease syndrome

It is expressed by the fact that the patient’s level of hemoglobin and red blood cells decreases. The patient complains of dizziness, general malaise, noise in the head, fainting, tachycardia.

The danger of vaculitis is that renal dysfunction may occur. This consequence occurs in many people who notice bleeding in urine, as well as acute form glomerulonephritis of an autoimmune nature. Typically, these symptoms appear 1–3 weeks after the rash appears.

In a relationship respiratory system malfunctions may also occur due to which the patient suffers from coughing and shortness of breath. In addition, there may be bloody discharge in the sputum. Symptoms of vaculitis also include disorders nervous system which can lead to negative complications. The patient may experience symptoms similar to those of meningitis and encephalitis. For example, a person suffers from severe headaches, loss of coordination, and tormented by convulsions.

Must be treated immediately, as negative consequences may occur. After all, this disease can cause dangerous violations in functioning digestive system and kidneys. As for the gastrointestinal tract, intense bleeding may occur, which can then develop into peritonitis, which can be fatal.

If consequences touch the kidneys, glomerulonephritis may develop. In most cases, it does not cause any clinical signs, so the patient does not feel it. However, this consequence significantly worsens the quality of kidney activity, as a result of which it is possible to form renal failure.

Treatment of vasculitis symptoms, photo can be seen below, it is carried out in a hospital, because it is impossible to control the course of the disease at home. The child's condition may deteriorate significantly if any complications manifest themselves. Usually, bed rest for three weeks is required, as well as dietary nutrition.

Medication treatment includes the use of sorbents, antiallergenic drugs, anticoagulants, and disaggregants. A plasmapheresis procedure is also necessary. In some cases, your doctor may prescribe antibiotics, corticosteroids, and other strong medications.

Parents should be well aware that under no circumstances should they treat their children for vasculitis on their own at home. At the first clinical signs, you must immediately consult a doctor, otherwise the consequences can be disastrous.

Vasculitis in adults: treatment

If the abdominal form is observed in adults, then intravenous nutrition is necessary. Doctors recommend taking medications that prevent vomiting, as well as drugs that can relieve the patient from pain.

If the patient notices blood discharge during bowel movements, then doctors recommend such remedies as Heparin and antiaggregants. Medicines are also used that are aimed at avoiding the occurrence of an allergic reaction. To activate immune system immunosuppressants are used. It is mandatory to prescribe a medicine such as Prednisolone.

As the disease progresses, patients are given plasma transfusions.. Also recommend plasmapheresis. must be treated in a hospital to prevent the pathology from becoming a chronic type of disease.

Vasculitis on the legs: treatment

In order to cure, many various means, both traditional and traditional medicine. During therapy, the most effective drugs are used: ointments, How Solcoseryl, which allows you to speed up the regeneration process, and Iruksol, helping to cleanse skin ulcers in areas where blood vessels are affected.

In combination with drug treatment, the patient needs to perform exercises every day " Bike" And " Scissors" This improves blood circulation in the legs. You should also do a soft stroking massage, which will speed up the healing process, and engage in hydrotherapy.

You can also carry out treatment with folk remedies. However, before choosing one or another remedy, you should definitely consult with your doctor. After all, some of the components used in them can cause an allergic reaction. Herbs allow you to cope with the inflammatory process in the body, strengthen the immune system, and get rid of pain.

The most common medications are the following:

• Collect horsetail and elder flowers 60 g each, mint and yarrow 40 g each. Mix the herbs, measure 60 g, pour 500 ml hot water, boil, leave for 12 hours. Drink 100 g 5 times a day. You can also apply this infusion to the damaged area for 20 minutes.
• Make a mixture of mountain arnica, calendula and Japanese sophora. Pour 10 g of herbs into 200 ml boiled water, leave for 3 hours, strain and consume 20 ml every 8 hours.
• Prepare an alcohol tincture from 3 crushed lemons mixed with 5 teaspoons of cloves, 400 g of sugar and 500 ml of alcohol. Leave the liquid in a dark place for two weeks. You need to drink 20 ml 4 times a day before meals.
• Make an ointment from 200 g of birch buds, ground to a powder and mixed with 1 kg of nutria fat. Then put the mixture in the oven for 3 hours, repeat this for a week, strain and use for local therapy affected areas.

Besides everything else, with vasculitis, it is important to cleanse the intestines. This can be done using an infusion, for the preparation of which you need 40 g of a mixture of the same amount of elecampane, tansy, immortelle, wormwood, pour 1 liter of hot water. Leave to brew for 2 hours, strain. You need to drink the infusion on an empty stomach, mixing equal proportions of the product and ordinary water, 2 times a day.

In addition, blood purification is necessary, for which bergenia is used. This is done with the help of an infusion, which is prepared from dried leaves of the herb, filled with boiled water. The medicine should be left to steep overnight, strain and drink 100 ml per day on an empty stomach.

Rash photo

In the treatment of this pathology, dietary nutrition plays an important role. Among many fruits, people suffering from vasculitis are best to consume green varieties of apples. However, at first they can only be eaten baked. After two to three weeks, you can gradually begin to eat them fresh.

Also among fruit You can choose bananas and pears, which will bring many benefits to the body. At the same time, you should know that you should not eat a lot of pears, as this can lead to malfunctions of the digestive system. These fruits are considered quite difficult for normal absorption by the body.

It is forbidden consume no products from the family citrus. Also, you should not eat currants, strawberries, or persimmons. Fruits that are red in color can greatly harm the patient. In addition, you should avoid using pineapples, apricots, peaches and mangoes.

Prohibited eat fruits such as carrots, tomatoes, beets, red peppers, cucumbers. These products have an adverse effect on the patient. You can eat green peppers, zucchini, potatoes, cauliflower. Vegetables are best stewed or steamed.

Experts prohibit eating eggs, as well as any products that contain them. For example, you should not eat pasta, dishes with dough containing a large number of eggs

Therefore, you will also have to give up mayonnaise.

The patient’s diet should not include dairy products such as milk, fruit yoghurts, ice cream, any cheeses, or cottage cheese. It is advisable to give preference to various kefirs and yoghurts that do not have any additives.

You are allowed to eat cottage cheese pastries, fermented baked milk and yogurt. If the patient likes porridge, then their preparation should be carried out in water, you can add a little butter or cream.

As for meat, you can eat rabbit, turkey, beef and lamb. The main thing is that it does not have high fat content. Chicken products need to be completely removed from your daily diet. You should also not eat pork, ham or any type of sausage.

Having considered what it is Vasculitis, photo, symptoms, treatment this disease, we can conclude that the disease is dangerous. After all, it can lead to negative consequences, which sometimes simply cannot be cured. In this regard, if clinical signs appear, you should immediately consult a doctor. Only timely diagnosis and pathology therapy will help to quickly cope with vasculitis and avoid complications.

Vascular diseases can occur almost unnoticeably or with the development of severe complications. In such cases, the main thing is to start treatment on time, which depends a lot on the correct diagnosis. The symptoms of various forms given in the material will help you notice the onset of the disease in time and consult a doctor.

Vasculitis is a group of disorders that are directly related to the destruction of blood vessels during the development of inflammation. IN pathological process Both arteries and veins may be involved. Lymphangitis in some cases is considered a variant of vasculitis.

The development of vasculitis is mainly associated with the migration of leukocytes, resulting in characteristic vascular damage.

Inflammation of the veins (phlebitis) or arteries (arteritis) are certain diseases, although both pathologies occur with vasculitis. There are many different types of vascular inflammation, and in each case the most characteristic symptoms are determined and appropriate treatment is carried out.

Video: What is vasculitis, diagnosis and treatment of vasculitis

Description

Vasculitis (Latin vasculum - vessel, -itis - suffix denoting inflammation) means “inflammation of blood vessels”. disease in medical terminology also known as arteritis and angiitis.

Inflammation is a natural response of the immune system to traumatic tissue damage or the introduction of infectious agents. Similar defensive reaction characterized by local tissue swelling, which can sometimes help the body cope with invading microbes.

In vasculitis, for some reason the immune system attacks healthy blood vessels, causing them to swell and collapse. It may be caused by an infection or a medication, although often the cause is not definitively determined.

Vasculitis can range from a minor problem that only affects the skin to more serious conditions that can cause problems with vital organs such as the heart or kidneys.

The main division of vasculitis is into primary and secondary.

• Primary vasculitis arise due to an inflammatory process that directly affects the vessels themselves.
• Secondary vasculitis accompanied by inflammatory damage to blood vessels against the background of another (main) disease.

Primary systemic vasculitis is also an autoimmune disease that occurs without any known cause, although genetic predisposition may make some people more susceptible.

Types of vasculitis

There are many types of vasculitis, among which it is often found eosinophilic granulomatosis with polyangiitis . The disease, also called Churg-Strauss syndrome, is a type of vasculitis that primarily affects adults between 30 and 45 years of age.

Against the background of vascular damage by improperly moving eosinophils, the following may occur:

• asthma;
• allergic rhinitis (cold-like symptoms caused by allergies);
• pain in muscles and joints;
• fatigue;
• loss of appetite and weight loss.

Vasculitis can also affect nerve fibers, causing weakness, tingling or numbness. In severe cases, it damages the kidneys or heart muscle.

Usually the pathology is treated with steroid drugs.

Giant cell arteritis is a type of vasculitis that often affects the arteries in the head and neck area. It is mainly determined in adults over 50 years of age.
The pathology is sometimes called temporary arteritis.

In severe cases, the disease can cause:

• pain and tenderness in the neck and head;
• pain in the jaw muscles while eating;
• double vision or vision loss;

The pathology also usually occurs along with polymyalgia rheumatica, when various muscles begin to ache.

The main treatment is steroid drugs.

Granulomatosis with polyangitis , also called Wegener's granulomatosis, is a type of vasculitis that primarily affects blood vessels in the nose, sinuses, ears, lungs, and kidneys. The disease is most often diagnosed in middle-aged or elderly people.

In the absence of timely treatment, the course of the disease can complicate:

• high temperature (fever);
• night sweats;
• inflammation of the sinuses (sinusitis);
• nosebleeds and crusty nose;
• shortness of breath and coughing up blood;
• kidney problems.

This serious disease can be fatal as it often leads to organ failure. This type of vasculitis is usually treated with steroid medications or other medications that reduce the activity of the immune system.

Henoch-Schönlein Purpura is a rare type of vasculitis that usually occurs in children and can affect the skin, kidneys, or intestines. The pathology is believed to be caused by the body's response to infection.

In advanced cases it can cause:

• a rash that looks like small bruises or reddish-purple spots;
• joint pain;
• stomach ache;
• diarrhea and vomiting;
• blood in urine or stool.

It usually occurs without serious consequences and tends to improve without treatment.

Kawasaki disease is a rare disease that can occur in children under five years of age. The main cause is considered to be infection, although it is not always possible to reliably determine.

Main manifestations:

• high temperature (fever) that lasts more than five days;
• rashes;
• swollen glands in the neck;
• red fingers or toes;
• Red eyes;
• redness of the lips, tongue, or mouth.

Kawasaki disease can affect the coronary arteries, the blood vessels that supply blood to the heart, causing some children to have problems with this organ.

The disease usually needs to be treated in hospital with aspirin and special immunoglobulin therapy.

Microscopic polyangiitis is a rare and potentially serious long-term type of vasculitis that most often develops in middle-aged people. It can affect any organ, but especially affects the lungs, kidneys and nerve fibers.

Main manifestations:

• rash;
• shortness of breath and coughing up blood;
• red and sore-looking eyes;
• a feeling of tingling or numbness;
• kidney problems.

This type of vasculitis is usually treated with steroid medications or other drugs that reduce the activity of the immune system.

Nomatosis polyarteritis is a rare type of vasculitis that particularly affects the arteries supplying the intestines, kidneys and nerves. It tends to develop in childhood or middle age. Sometimes it can be caused by an infection such as hepatitis B, but the exact cause is unclear.

Main manifestations:

• pain in muscles and joints;
• stomach ache ( abdominal cavity), especially after eating;
• rash;
• tingling sensation or numbness;
• bleeding and ulcers in the intestines.

The pathology can be very serious if there is no treatment.

Therapy is based on steroid drugs and sometimes other drugs that reduce the activity of the immune system.

Diagnostics

Most of the procedures used during the examination and treatment of a patient with vasculitis are carried out in the diagnosis and treatment of other diseases, so they are not specific to vasculitis. However, without them, a reliable and accurate diagnosis of vascular inflammation is impossible.

During the examination of the patient, various modern methods are used.

• Abdominal ultrasound examination

It is based on the use of sound waves, with the help of which a picture of the organs and anatomical structures located in the abdomen is created. This test can show whether there are abnormalities in the abdominal cavity.

• Angiography

This method evaluates the structure and passage of blood vessels, resulting in the identification of blockages, inflammation or other abnormalities. There are many ways to perform angiography. Ultrasound is most often used for examination large vessels without the use of x-rays or dyes. Magnetic resonance imaging (MRI) uses a magnetic field to create detailed images of certain blood vessels and, if necessary, can be combined with special dyes (contrast agents) given by injection to the patient. Computed tomography (CT), which uses X-rays, evaluates the structure of blood vessels. It is usually performed using contrast dyes. A positron emission tomography (PET) scan requires an injection of radioactive drugs and can be helpful in identifying where blood vessels are inflamed.

• Biopsy

During the procedure, a small piece of tissue is removed from the affected area or organ, such as the skin or kidney. The tissue is then examined under a microscope by a pathologist. If necessary, special tests may be performed to identify disease affecting the organ.

• Bronchoscopy

A procedure during which the doctor examines the patient's respiratory tract (trachea and bronchi). The purpose of the study is to determine the area of ​​damage, and biological samples may also be collected for biopsy or washing. This allows you to clarify the cause of the disease, especially if it developed due to infection. The trachea and bronchi are the main tubes that carry air to the lungs. Typically a fiberoptic bronchoscope (thin, flexible, with a telescope at the end) is used.

• CT scan(CT)

Gives more details about internal organs than conventional radiography (X-ray).

• DEXA scan

Also known as dual-energy X-ray absorptiometry. This is a test that measures bone density. Can be used to identify or monitor bone strength, especially in long-term patients treated with steroid drugs.

• Electrocardiogram

A simple and painless diagnostic method for recording the electrical activity of the heart. Often provides useful information about the condition of the heart and can provide information about whether the organ is associated with vasculitis.

• Electromyography

Electrical stimulation of muscles (usually in the arms or legs) is assessed to look for evidence of abnormal muscle function, such as in vasculitis. Often the test is performed in combination with a nerve conduction study.

• Echocardiography

An ultrasound test that uses sound waves to create images of the heart. The test reveals the size and shape of the heart, as well as the order in which the chambers and valves work.

• Positive emission tomography

The test is also known as a PET scan. During this procedure, three-dimensional images are taken that show the level of metabolic activity, which is an indicator of inflammation.

• Spirometry

Refers to pulmonary function tests. The volume of the lungs, the amount of air inhaled and exhaled, and how well the transfer of oxygen from the lungs to the blood occurs is determined. This may be useful for monitoring patients whose lungs or airways have been affected by vasculitis.

• Tracheostomy

Tracheostomy is sometimes necessary for patients whose main airway is blocked or narrowed as a result of damage caused by vasculitis. This provides direct access to the trachea by making a surgical opening in the anterior neck. As a result, air enters directly into the lungs, allowing patients to breathe properly when their upper lungs are blocked. respiratory tract.

Tracheostomy may be a temporary measure, especially for patients who have severe vasculitis. It can also be used permanently if irreversible changes have occurred in the body. For patients with a permanent tracheostomy, a special tube is inserted to hold the opening open and allow normal speech. This allows you to live a more or less normal life.

• Analysis of urine

A simple but very important urine quality test identifies abnormal levels of protein or blood cells in the urine. If such signs are detected, then kidney damage is diagnosed.

Directions for treatment for vasculitis

• Vascular plastic surgery

Treatment for narrowed, scarred, or “broken” blood vessels involves widening one or more narrowed arteries so that blood can flow more easily through the organ or limb it supplies. A stent may also be part of an angioplasty. In this case, a narrow metal tube is inserted into the blood vessel at the site of the narrowing and straightened, which helps open the blood vessel and prevent the narrowing from happening again.

• Anticoagulant therapy

Anticoagulants are prescribed to thin the blood. With their help, the risk of thrombosis and blockage of blood vessels is reduced.

Patients taking anticoagulants such as warfarin should be aware of the importance of periodic blood clotting checks. This will avoid complications such as unexpected bleeding.

• Antihypertensive treatment

It is based on taking medications that control blood pressure. Necessary if the patient has hypertension. In general, blood pressure should be monitored in all cases of vasculitis. The occurrence of hypertension due to vasculitis can lead to kidney damage.

• Dialysis

When the kidneys do not work properly to eliminate toxins from the body, acids and fluid accumulate. The dialysis process helps cleanse the blood and support patients with severe kidney failure. Sometimes this treatment is given temporarily (a few days, weeks, or months) to allow the kidneys time to recover if there is reversible damage. If kidney damage is not reversible, dialysis treatment is performed continuously. For patients requiring long-term dialysis, the procedure is done at home or in an outpatient setting.

• Plasma exchange or plasmapheresis

This treatment is sometimes used in patients with severe vasculitis when antibodies are thought to play an important role in causing the disease. Treatment involves removing antibodies from the blood using equipment and returning “purified” blood back into the patient’s bloodstream. This may require transfer of blood products to the patient, including plasma, albumin, or immunoglobulin. Medicines may also be used to cleanse the blood and prevent it from clotting in the machine.

• Vaccination

Patients with vasculitis, especially those who are immunocompromised, should not receive live vaccines. If you take drugs against influenza and pneumonia, they are not live vaccines, and therefore are recommended for use by patients with vasculitis.

Video: Vasculitis - treatment of vascular disease

From this article you will learn: characteristics of vasculitis, what kind of disease it is, and how to treat it. Types of pathology, treatment methods.

Article publication date: 04/30/2017

Article updated date: 05/29/2019

Vasculitis – what is it? This is a group of diseases accompanied by inflammation and subsequent necrosis (death) vascular wall. This group of pathologies leads to a significant deterioration in blood circulation in the tissues surrounding the vessel. Different forms of these ailments have both characteristic and general symptoms (fever, weight loss, rash that does not disappear with pressure, joint pain). If left untreated, the primary lesion may spread and cause damage to other tissues or organs. Subsequently, the disease can lead to disability and even death.

So far, vasculitis remains insufficiently studied, and experts have not come to a consensus on the causes and mechanisms of inflammation, classification and treatment tactics. Now this disease is classified as a systemic disease. connective tissue, and is treated by rheumatologists. If necessary, infectious disease specialists and dermatologists may be involved in therapy.

According to statistics, vasculitis affects both men and women equally often, and they are most often detected in children and the elderly. Every year the number of such rheumatologist patients increases, and experts believe that this increase in incidence is associated with the uncontrolled use of immune stimulants and environmental deterioration.

Types of vasculitis

A disease such as vasculitis is classified according to various parameters.

Based on the underlying cause, the following two forms of the disease are distinguished:

1. Primary - damage to the vascular wall is caused by unknown reasons, presumably it is provoked by disruptions in the immune system.
2. Secondary - damage to the vascular wall is a reaction to infections (tuberculosis, hepatitis, syphilis), systemic lesions (collagenosis, systemic lupus erythematosus, reactive arthritis), sarcoidosis, cancerous tumors, helminthic infestations or chemicals.

According to the severity of the course, vasculitis can be:

• mild degree - manifests itself only as a mild rash and does not cause a deterioration in the general condition;
• moderate degree - the patient has a profuse rash, joint pain, blood in the urine, and the general condition is moderate (loss of appetite, weakness);
• severe - the patient has a profuse rash, significant disorders in organs and joints, pulmonary and intestinal bleeding appears, kidney failure develops, and the general condition is severe.

Depending on the type of inflamed vessels, the following forms of vasculitis are distinguished:

• capillaritis – the capillary walls are inflamed;
• arteriolitis – the walls of the arterioles are inflamed;
• arteritis – arterial walls are inflamed;
• phlebitis – the venous walls are inflamed.

Depending on the location of the affected vessels, the following forms and types of vasculitis are distinguished:

General symptoms

The symptoms of vasculitis are extremely varied, and the most characteristic feature These ailments include a rash on the skin. The severity of the signs of the disease and the general condition of the patient largely depend on the form and type of vasculitis. In severe cases and if left untreated, the disease can cause disability or death.

Rash

Signs of skin rashes due to vasculitis can be varied, but a number of them make it possible to distinguish this disease from others:

• the appearance of a rash is often associated with a past infection;
• the rash appears against the background of allergies, systemic, autoimmune or rheumatic diseases;
• the rash is located relatively symmetrically;
• the first elements of the rash appear on the legs (usually in the shins);
• elements of the rash are prone to hemorrhage, edema and necrosis;
• the rash is often represented by different elements that change their color, size and shape over time.

Patients with vasculitis may experience the following types of rashes:

1. Stains. They are red or pink rash elements that do not rise above the level of the skin. Caused by a rush of blood in response to inflammation.
2. Hemorrhagic purpura. Elements of rashes occur with significant damage to the vessel wall and hemorrhage. The rash may look like macules or telangiectasias that are purplish in color. The dimensions of elements with uneven contours can reach 3–10 mm. After some time, the rashes turn blue and then acquire a yellowish tint. After pressing, the rash does not disappear.
3. Hives. This rash is caused by an allergic reaction and is accompanied by burning, tingling and itching. It appears as pink or red bubbles with irregular contours.
4. Subcutaneous nodes. Such rash elements are caused by uncontrolled growth of connective tissue and epidermis. They appear as raised semicircular or flat nodules. Their size can vary from a few millimeters to 1–2 cm. They are painful, and over time, an area of ​​necrosis may appear in their center due to a significant circulatory disorder. Subsequently, the skin in this place of the nodule turns black and begins to be rejected.
5. Bubbles. Violations of the permeability of vascular walls in a certain area of ​​the bloodstream lead to the release of the liquid part of the blood under the skin. In such places bubbles larger than 5 mm appear. They are filled with transparent contents that may contain blood.
6. Ulcers and erosions. Subcutaneous nodes formed during vasculitis disintegrate over time, and in their place erosions (superficial damage) or deeper skin defects - ulcers - appear. When infected, they can fester.

Intoxication

Vasculitis is accompanied by circulatory disorders, leading to the formation of toxins, poisoning of the body and changes in metabolism. These processes cause the patient to experience the following symptoms:

• decreased exercise tolerance and weakness;
• loss of appetite and weight loss (up to 0.3–1 kg every month);
• frequent drowsiness;
• headaches (their intensity depends on the severity of the disease);
• temperature rise to 37.5–40 degrees (depending on the severity of the disease).

Nervous system lesions

Exposure to toxins and damage to nervous tissue caused by circulatory disorders and hemorrhages during vasculitis provoke the appearance of the following symptoms:

• sudden changes in psycho-emotional state;
• seizures;
• muscle weakness, incomplete paralysis of arms and legs,
• changes in sensitivity (usually of the “socks” and “gloves” type – that is, in these areas of the body);
• hemorrhages in the brain leading to the development.

Visual impairment

Insufficient blood supply and nutrition to the organs of vision observed with vasculitis can cause one- or two-sided damage to them:

• constantly progressive deterioration of vision (up to complete blindness);
• swelling and redness of the eye;
• feeling of difficulty moving the eyeball;
• protrusion of the eye.

Respiratory damage

The presence of an inflammatory reaction and impaired permeability of vascular walls during vasculitis leads to swelling and inflammation of different parts of the respiratory system. As a result, the following respiratory diseases may develop:

1. Prolonged runny nose.
2. Prolonged sinusitis and sinusitis.
3. Destruction of bone walls maxillary sinus or nasal septum.
4. Prolonged bronchitis with an asthmatic component.
5. Bronchial asthma.
6. Pleurisy.
7. Pneumonia.
8. Bronchiectasis.

When the walls of blood vessels rupture, the patient develops bronchopulmonary bleeding of varying intensity.

Kidney damage

Many types of vasculitis lead to impaired nutrition and kidney function. Initially, the patient shows signs of decreased function, manifested by the following symptoms:

• lower back pain;
• fever;
• swelling;
• decreased volume of urine excreted;
• protein and blood in the urine.

Subsequently, the disturbance of blood circulation and nutrition in the renal tissues becomes more pronounced, and the tissues of these organs are affected more massively. Due to such changes, the patient develops acute and then chronic renal failure.

Joint damage

Vasculitis is accompanied by damage to the joint capsule, which is caused by the penetration of fluid into it, the development of inflammation and swelling. Those who suffer most often are knee joints, and the patient develops the following symptoms:

• redness, swelling and rash in the knee area;
• intense pain leading to difficulty in motor function.

A few days later inflammatory process spreads to neighboring joints and knee pain becomes weaker. Typically, such joint damage resolves itself and does not lead to irreversible consequences.

Lesions of the digestive organs

Damage to the walls of the vessels of the mesentery and intestines causes circulatory problems and leads to hemorrhages. As a result, an inflammatory reaction develops and a patient with vasculitis develops the following symptoms:

• paroxysmal and intense abdominal pain, intensifying half an hour after eating;
• nausea and vomiting;
• frequent, watery stools (sometimes with blood inclusions).

Massive vascular damage can cause atrophy, gradual destruction and rupture of the intestinal wall. With such large-scale lesions, the patient develops peritonitis.

Treatment

Treatment of vasculitis should be comprehensive, and its tactics depend on the severity and type of disease. It can be performed on an outpatient basis or in a rheumatology department.

Indications for hospitalization of a patient with vasculitis are as follows:

1. Moderate or severe form.
2. Debut or exacerbation of the disease.
3. Pregnancy period.
4. Childhood.
5. Hemorrhagic vasculitis.

During the acute phase of the rash, patients are advised to remain in bed to help the rash disappear and stabilize blood circulation. A week after the appearance of the last elements of the rash, the regimen is gradually expanded.

Drug therapy

The choice of certain medications for the treatment of vasculitis can only be made by a doctor who takes into account the patient’s examination data, the severity and type of the disease. At mild form The medications are prescribed for 2–3 months, for moderate cases – for about 6 months, and for severe cases – up to a year. If vasculitis is recurrent, then the patient is given therapy in courses of 4–6 months.

The following drugs can be used to treat vasculitis:

• non-steroidal anti-inflammatory drugs (Ortofen, Piroxicam, etc.) - eliminate inflammatory reactions, joint pain, swelling and rash;
• antiplatelet agents (Aspirin, Curantil, etc.) – thin the blood and prevent the formation of blood clots;
• anticoagulants (Heparin, etc.) – slow down blood clotting and prevent thrombus formation;
• enterosorbents (Nutriklinz, Thioverol, etc.) – bind toxins and bioactive substances formed during illness in the intestinal lumen;
• glucocorticosteroids (Prednisolone, etc.) – have an anti-inflammatory effect in severe vasculitis, suppress the production of antibodies;
• cytostatics (Azathioprine, Cyclophosphamide, etc.) - prescribed when glucocorticosteroids are ineffective and rapid progression of vasculitis, suppress the production of antibodies;
• antihistamines (Suprastin, Tavegil, etc.) - prescribed only to children for initial stages vasculitis in the presence of drug or food allergies.

Non-drug therapy

In case of vasculitis, in order to cleanse the blood of substances that cause and aggravate the disease, the attending physician may recommend that the patient undergo various methods of gravitational blood surgery:

1. Immunosorption – venous blood cleaned by passing through a device with an immunosorbent.
2. Hemosorption - blood is passed through a device with a sorbent that cleans it of antibodies, immune complexes and antigens.
3. Plasmapheresis - blood passes through a special device that purifies or replaces its plasma.

Hypoallergenic diet and nutrition

Vasculitis often predisposes to an allergic reaction, and to prevent such a complication, patients are advised to exclude the following foods from their diet:

• eggs;
• chocolate;
• red fruits and berries (especially wild strawberries);
• citrus;
• honey, royal jelly, pollen;
• products with flavor enhancers, stabilizers, dyes and non-natural flavors (sausages, flavored cheeses, pates, crackers, chips, etc.);
• mushrooms;
• pastries made from butter dough;
• canned food;
• coffee and strong tea;
• spicy, salty and fried foods;
• alcohol;
• individually intolerable products.

Herbal medicine, non-traditional and folk methods

Self-medication of vasculitis is unacceptable, because taking certain medicinal herbs can provoke allergies and aggravate the course of the disease. In the absence of contraindications, a rheumatologist may recommend the following herbal remedies, non-traditional and folk methods:

• liquorice root;
• herbal mixtures based on calendula, horsetail, poplar buds, string, elderberry flowers, peppermint, yarrow, etc.;
• hirudotherapy (medicinal leeches).

Forecasts

The prognosis of this disease depends on its type and form, the age of the patient, the presence of complications and the timeliness of starting therapy. The five-year survival rate of patients with severe vasculitis, treatment of which was started immediately and with the use of glucocorticosteroids and cytostatics, is 90%. Without timely treatment, this figure is only 5% and leads to disability and death.

The following clinical cases can worsen the prognosis for vasculitis:

1. Kidney damage.
2. Damage to the central nervous system.
3. Damage to the coronary vessels and aorta.
4. Damage to the digestive organs.
5. Development of vasculitis after 50 years.

These facts mean that people with such diseases need constant medical supervision and strict adherence to all doctor’s recommendations. This attitude towards their health will help them avoid the development of serious complications.

Systemic vasculitis – large group ailments characterized by inflammation followed by destruction of the walls of small, medium and large vessels. As a result, ischemia of tissues and organs develops. Systemic vasculitis is characterized by a relapsing course, but it can also often worsen. Symptoms of illnesses largely depend on the location of the blood vessel, its caliber, as well as on the activity of the inflammatory process.

Clinicians refer to systemic vasculitis as:

• Kawasaki disease;
• Henoch-Schönlein syndrome. It is also known under another name - hemorrhagic vasculitis (one of the most common forms of pathology);
• Churg-Strauss syndrome;
• nonspecific aortoarteritis. In medicine, this disease is also known as Takayasu syndrome;
• cryoglobulinemic vasculitis;
• microscopic polyangiitis;
• Wegener's granulomatosis.

All of the above systemic vasculitis differ from each other in the localization of the inflammatory process and in the severity of its course. It should be taken into account that some forms exclusively affect skin covering and bring only mild discomfort to the patient, but others are extremely difficult and can even lead to death if they are not diagnosed in time and correct treatment is not carried out.

This group of ailments can be aggravated by damage to the visual apparatus, skin, heart, lungs, kidneys, joints, etc. An accurate diagnosis can only be made after several laboratory tests, visceral angiography and based on the results of a biopsy.

Systemic vasculitis is quite rare, but in recent years there has been a tendency to increase the prevalence of this pathology. Most often, men from the middle class are affected age group. But also some forms of the disease primarily affect women (Horton's disease, Takayasu's arteritis). Sometimes systemic vasculitis may occur in children.

Causes

The reasons for the progression of this group of diseases have not yet been fully studied by medicine. But there are already several theories directly related to the occurrence of systemic vasculitis. Clinicians are more inclined to believe that illnesses develop as a result of previously suffered severe viral diseases. As a result of this, the immune system begins to react abnormally to the infectious agent, which gives impetus to the progression of systemic vasculitis. In medicine, it is not uncommon for a person to develop vasculitis after suffering from viral hepatitis.

The second, most reliable theory, is based on the autoimmune nature of vasculitis. In this case, clinicians suggest that the development of the disease is facilitated by the fact that the immune system begins to recognize the cells that make up the blood vessels as foreign and begins to destroy them.

There is also an assumption that systemic vasculitis can be transmitted at the genetic level. It is believed that unfavorable factors environment, as well as hereditary predisposition, greatly increase a person’s chances of developing vasculitis.

Classification

Classification by nature of occurrence:

• primary vasculitis;
• secondary vasculitis.

Primary vasculitis progress independently, without underlying ailments. They are characterized by an inflammatory process that affects the vascular walls. The development of this type of disease is associated with impaired immune reactivity. The inflammatory process penetrates all layers of the vascular wall. As a result, vessel occlusion and microcirculatory disorders develop, which, in turn, lead to ischemia. In the most severe clinical situations, tissue necrosis or even tissue necrosis may develop.

Secondary vasculitis is a disease that progresses against the background of existing pathology in the human body. Clinicians consider it as a complication or as a local optional manifestation.

The modern classification of vasculitis provides for their distribution into groups depending on the caliber of the affected vessels:

• damage to large vessels;
• damage to medium-sized vessels;
• damage to small vessels.

This classification is relevant and is used in medical institutions for accurate diagnosis and diagnosis.

Symptoms

Symptoms directly depend on the type of vessels that are affected. If this disease progresses, the patient experiences loss of appetite, fever, general weakness, weight loss, muscle and joint pain.

Also, the main symptoms can be supplemented with signs that are characteristic of various types of vasculitis.

• Takayasu arteritis. This type of vasculitis primarily affects women. “Attacks” the large arteries of the body. Main symptoms: headaches, feeling of cold or numbness in the lower extremities, complete absence of pulse in them or low pulse pressure, disorders visual function, increased blood pressure;
• Behçet's disease. It primarily affects young men of working age. Main symptoms: the formation of ulcers, localized mainly on the genitals and in the mouth, damage to the skin, inflammation of the organs of vision;
• Buerger's disease. This disease is also known as thromboangiitis obliterans. It is characterized by the formation of small blood clots in the vessels of the extremities. Most often, such vasculitis occurs in representatives of the stronger sex. Symptoms: severe pain in the limbs, formation of ulcers on the fingers;
• giant cell arteritis. This type primarily affects people over 50 years of age. The pathological process begins in inflammation of the arteries of the head. As a result, the patient experiences severe headaches, pain in the cervical muscle structures, numbness of the tongue and pain when chewing food. Gradually, the symptoms intensify and the vessels of the visual apparatus are affected;
• Wegener's granulomatosis. With this type, the vessels of the nose, as well as the paranasal sinuses, kidneys and lungs are affected. At the early stage of development of the pathology, the symptoms are less pronounced, but as it progresses, difficult nasal breathing and nosebleeds appear;
• microscopic polyangiitis. This pathology affects small-caliber vessels in the skin, kidneys and lungs, and nerve endings. The patient gradually begins to lose weight, ulcers form on the skin, and fever develops. When the kidney vessels are damaged, inflammation of the glomeruli (glomeruli) is observed, which leads to a decrease in their function;
• cryoglobulinemic vasculitis. Its characteristic symptom is the appearance of purpura on the lower extremities. The person's joints also become inflamed. As the pathology progresses, they experience a feeling of numbness. This feature is due to the fact that vasculitis has already damaged the nerve endings;
• Henoch-Schönlein purpura. The pathology mainly affects young children, but it can also occur at any age. With this purpura, the vessels of the kidneys, skin, joints and intestines are affected. As a result of this, severe abdominal pain appears, purpura on the extremities, and urine mixed with blood may also be released;
• Churg-Strauss syndrome. This vasculitis exclusively affects the blood vessels of the lungs;
• polyarteritis nodosa. The disease can affect blood vessels located anywhere in the human body. The symptoms are quite extensive. There is purpura, ulceration, deterioration of kidney function, severe pain in a stomach.

Diagnostics

Diagnostics includes full examination patient with a neurologist, rheumatologist, nephrologist, as well as other specialists of a narrow profile. At the appointment, specialists clarify the history of life and the disease itself, and also conduct an examination. Diagnosis of systemic vasculitis includes laboratory and instrumental techniques.

Laboratory diagnostic methods:

• , including and ;
• blood test for CRP and RF.

Instrumental diagnostic methods:

• X-ray;
• echocardiography;
• angiographic examination;
• biopsy of affected tissue.

Treatment

Treatment of vasculitis is carried out only after a thorough diagnosis and clarification of what type of disease has affected the person. It largely depends on which system or organ in the body was affected, as well as on the stage of development of the pathology. process.

In the case of the progression of allergic vasculitis, in which only the skin is affected, in some situations doctors even do without the use of synthetic drugs. It is worth paying attention to the fact that the treatment is aimed at completely eliminating the inflammatory process that has affected the vascular wall, restoring the normal functioning of organs and systems, and also avoiding the development of possible severe complications.

In almost all cases, patients are prescribed hormone therapy glucocorticoids. This treatment tactic allows you to quite effectively and quickly eliminate inflammation in the blood vessels and reduce the abnormal activity of the immune system. GMPs are also used as an additional means. They are necessary to also eliminate inflammation and reduce painful sensations. For hemorrhagic vasculitis, the course of treatment must include antimicrobial drugs. In order to improve blood circulation and prevent the formation of blood clots in bloodstream Prescribe medications that thin the blood.

If conservative treatment does not bring improvement with the help of hormonal drugs, then in this case it is indicated to use chemotherapy using cytostatics.

In severe cases, blood purification is required during treatment. Then doctors resort to hemosorption and plasmapheresis.

Prevention

In order not to treat vasculitis, you should take measures to prevent this disease:

• complete rest;
• healthy sleep;
• hardening of the body;
• timely treatment of infectious diseases;
• proper nutrition.

It is extremely important to avoid stress on the immune system, which can lead to a malfunction of the entire immune system and can cause the progression of vasculitis.

Vasculitis- These are diseases that affect blood vessels. Subsequently, the pathological process often spreads to different organs and tissues.

There are a large number of different types of vasculitis, each of which is accompanied by damage certain type vessels and their own specific symptoms.

The most common types of vasculitis:

• Urticarial vasculitis– a disease in which small vessels are damaged, mainly venules (small veins) and spots appear on the skin like urticaria.
• Allergic vasculitis– vascular damage due to various allergic reactions.
• Hemorrhagic vasculitis (Henoch-Schönlein disease) is a disease in which there is damage to the capillaries and small arteries.
• Periarteritis nodosa– a disease that primarily affects small and medium-sized vessels.
• Nonspecific aortoarteritis (Takayasu disease) is a disease that affects the aorta and the large arteries branching from it.
• Wegener's granulomatosis– vasculitis, which affects small vessels of the upper respiratory tract, lungs and kidneys.

Types of systemic vasculitis depending on origin:

• primary– develop as an independent disease;
• secondary– arise as a manifestation of another disease.

General signs of all types of vasculitis:

• Unable to determine root cause.It is not possible to identify the factor that initially led to the onset of the disease.
• Same development. As a result of one reason or another, immunity disorders occur and autoimmune reactions develop. Antibodies are produced, which, combining with various substances, form immune complexes. The latter settle on the walls of blood vessels and cause inflammation.
• Chronic course. All systemic vasculitis occurs over a long period of time. Exacerbations and remissions (improvement of condition) alternate.
• The same factors usually lead to exacerbations: administration of vaccines, various infections, hypothermia, prolonged exposure to the sun, contact with allergens.
• Damage to various organs and tissues: skin, joints, internal organs. Autoimmune processes develop throughout the body, but mainly in those places where there are large concentrations of blood vessels.
• For all types of vasculitis, medications that suppress the immune system help.

Anatomy of blood vessels

The wall of any artery consists of three layers: inner, middle and outer. They can have different structures and thicknesses, depending on the size, position and function of the artery.

Types of arteries:

• elastic;
• muscular;
• mixed.

The structure of the walls of arteries depending on the type:

Type of arteries	Wall structure
Elastic. The aorta and other large vessels are structured according to the elastic type. Their task is to provide a constant flow of large amounts of blood under high pressure.	The inner layer is represented by endothelium, which makes up 20% of the wall thickness. These are the cells lining the lumen of the vessel from the inside. They provide normal movement blood and prevent the formation of blood clots. Under the endothelium there is loose tissue connecting it to the middle layer. It is in it that cholesterol plaques form during atherosclerosis.
	The middle layer is represented by multilayer elastic membranes, in which there are holes - windows.
	The outer layer of elastic arteries is thin and consists of loose tissue and fibers. It is designed to protect the vessel from overstretching and rupture. The vessels and nerves supplying the artery pass through here.
Muscular. Arteries of the muscular type are also called distributive. Their walls contain muscle fibers, with the help of which the lumen of the vessel can quickly change. Muscle-type arteries can increase or restrict blood flow to a particular part of the body. Muscular arteries are large vessels that are branches of the aorta and supply blood to large areas of the body.	The inner layer of muscular arteries is practically no different from the elastic one. It consists of: endothelium; a layer of loose tissue underneath; membrane separating the inner layer from the middle one.
	The middle layer consists of muscle fibers that are arranged in a spiral and cover the entire vessel. By contracting, they reduce the lumen of the vessel and partially block the blood flow.
	The outer shell is a fabric with a large number of fibers. Nerves and blood vessels pass through it.
Mixed (muscular-elastic).	In structure they occupy a middle position between arteries of the muscular and elastic types. Their middle layer contains both fibers and muscle cells. Arteries mixed type- These are small and medium-sized vessels. As their diameter decreases, the walls become thinner.
Arterioles	Arterioles are the smallest arteries that connect the arterial system to the capillaries. The wall of arterioles is very thin. It consists of the same layers as the wall of the arteries: The inner layer is the endothelium, located on a membrane film. The middle layer is muscle cells. They are arranged in two layers. The junction between the arteriole and the capillary is covered by one muscle cell: by contracting and relaxing, it regulates the flow of blood into the capillaries. There are spaces between the endothelial cells of arterioles. Therefore, hormones and other substances that enter the bloodstream can quickly act directly on muscle cells. The outer layer of arterioles consists of connective tissue and is very thin.
Capillaries	Capillaries are the final section of the bloodstream. These are the smallest vessels connecting arterioles to venules. Gas exchange between blood and tissues occurs in capillaries; here arterial blood turns into venous blood. IN different organs There are different numbers of capillaries. Their density is highest in the brain and heart. Normal in calm state only 50% of capillaries are active.

Allergic vasculitis

Allergic vasculitis is an allergic-inflammatory disease that primarily affects small vessels located in the skin. It can occur in different ways and be accompanied by the appearance of various skin rashes. Some of its forms are identified as independent diseases. This creates difficulties during diagnosis. Allergic vasculitis can develop at any age, equally often in men and women.

Causes of allergic vasculitis

Despite the word “allergic” in the name, this type of vasculitis is caused by a combination of different factors:

• infections: staphylococci and other bacteria, viruses, fungi;
• chronic foci of inflammation in the body: tuberculosis, chronic cystitis, adnexitis, sinusitis, tonsillitis, etc.;
• frequent colds;
• taking certain medications: antibiotics, painkillers, sedatives, contraceptives, etc.;
• contact with certain chemicals(mainly occupational hazards);
• exposure to radiation, frequent exposure during the radiation therapy at oncological diseases;
• cardiovascular diseases : arterial hypertension, varicose veins, heart failure;
• some chronic diseases: obesity, type II diabetes mellitus, gout etc.

Manifestations of allergic vasculitis

The symptoms of allergic vasculitis depend on the form in which it occurs.

Manifestations of allergic vasculitis depending on the form of the disease:

Description	Appearance of elements on the skin
Hemorrhagic vasculitis (Henoch-Schönlein disease) - see below, described separately.
Allergic arteriolitis of Rutera
A lot of different types skin rashes: blisters, red spots, spider veins, pustules, blisters, ulcers. Headache. Increase in body temperature, usually up to 37⁰C. Pain, inflammation in the joints.
Nodular necrotizing vasculitis
This form of the disease usually occurs chronically over a long period of time. There is always a significant deterioration in the patient's general condition. Red spots, hemorrhages, and nodules appear on the skin, which then ulcerate.
Erythema nodosum
The disease can occur in acute or chronic form. Small nodules and larger nodules form on the skin. The lesion is mainly localized on the anterior surface of the legs. There may be pain and inflammation in the joints.

Diagnosis of allergic vasculitis

The manifestations of different types of allergic vasculitis vary greatly. Therefore, after identifying complaints and examining the patient, it is very difficult to make a diagnosis.

Examination for allergic vasculitis:

Diagnostic method	What does it reveal?	How is it carried out?
General analysis blood	General clinical analysis. It is carried out in patients with suspected diseases. In allergic vasculitis, inflammatory changes are detected: acceleration of erythrocyte sedimentation; increase in quantity immune cells– leukocytes.	Blood is drawn from a finger or a vein, usually early in the morning.
Skin biopsy	The main method for diagnosing allergic vasculitis. The doctor takes a small piece of the patient's skin and sends it to the laboratory for examination under a microscope. After this, you can say exactly what pathological changes are occurring in the skin.	The doctor obtains a piece of skin using a special razor (a small piece of skin is removed, the procedure is almost painless) or a needle.
	Aimed at identifying specific antibodies and immune cells that are involved in the development of an allergic reaction.	For immunological studies, a small amount of blood is usually taken from a vein.

Also, in case of allergic vasculitis, an examination is aimed at:

• identification of chronic foci that could contribute to the onset of the disease;
• identifying infections that could contribute to the onset of the disease;
• identification of complications from joints, heart, etc.

The examination program is drawn up individually by the doctor.

Treatment of allergic vasculitis

Drug name	Description, effects	Mode of application
Antiallergic drugs: Pipolfen; Telfast; Calcium chloride, etc.	Suppress allergic reactions, which underlie vascular inflammation in allergic vasculitis.	Suprastin: For adults: 1 tablet 3 – 4 times a day For children Pipolfen: For adults: 0.5 ampoules intramuscularly, 1 time per day or every 4 to 6 hours, depending on the doctor’s prescription. For children: depending on age and weight, as prescribed by a doctor. Telfast Adults and children over 12 years of age take 1 tablet daily.
Venoruton (syn.: Rutoside)	Effects: strengthens vascular walls; reduces the fragility of small vessels; prevents the formation of blood clots; protects the inner surface of the walls of blood vessels from the action of various substances.	Release form: In capsules of 300 mg. Mode of application: Take 1 capsule 3 times a day until symptoms disappear.
Dicynone (syn.: Etamsylate)	Effects: strengthens the walls of blood vessels; normalizes the permeability of vascular walls for various substances; improves blood circulation in the skin and in various organs; normalizes the process of blood clot formation.	Release forms: ampoules with solution for injection, 2 ml; tablets 250 mg. Directions for use: In ampoules: intramuscularly, 1 ampoule 2 times a day. In tablets: 1 - 2 tablets 3 times a day. The duration of treatment is determined by the attending physician.
Askorutin	Combined vitamin preparation, combination ascorbic acid(vitamin C) and rutin (vitamin H). Both vitamins have a strengthening effect on the vascular wall, protect cells and tissues from oxidation by free radicals.	Release form Mode of application:
Prodectin (syn.: Pyricarbate)	This drug belongs to the group of angioprotectors - drugs that protect the walls of blood vessels from damage. Effects: restoration of blood flow in small vessels; elimination of inflammation; decreased permeability of the vascular wall to various substances; suppression of platelet adhesion and reduction of blood clotting; preventing the formation of atherosclerotic plaques; eliminating redness and itching of the skin.	Release forms: ointment; pills. Methods of application: ointment: apply a thin layer to the skin, rubbing lightly, 2 times a day, apply a bandage on top; pills: take 250 – 500 mg of the drug 2 times a day, as prescribed by your doctor.
Aminocaproic acid	It is a hemostatic agent. It is used for allergic vasculitis, accompanied by hemorrhages from small vessels.	Release forms: powder in packages for oral administration of 500 g; 5% solution in 100 ml bottles for intravenous administration; granules 60 g for children. Methods of application: In the form of powder and granules, aminocaproic acid is taken every 4 hours at the rate of 0.1 g of the drug per kilogram of body weight. 100 ml of solution is administered intravenously as a dropper. If necessary, repeat the administration after 4 hours (strictly as prescribed by the doctor!)
Aescusan	A drug plant origin, horse chestnut extract. It is an angioprotector, protects blood vessels from damage. Effects: decreased permeability of the vascular wall; increased tone of small vessels; elimination of inflammation.	Release forms: solution in bottles for oral administration; pills. Mode of application: solution: 10 – 20 drops 3 times a day; pills

Treatment methods for severe allergic vasculitis:

• glucocorticoids– adrenal cortex drugs that suppress the immune system;
• cytostatics– drugs that suppress the immune system;
• hemosorption and plasmapheresis– hardware methods for purifying blood from immune complexes and toxic substances(see below for periarteritis nodosa).

Urticarial vasculitis

Urticarial vasculitis can be considered a type of allergic vasculitis. Synonym for the name of the disease - The disease is rare. Outwardly it resembles an allergic reaction like urticaria.

Causes of urticarial vasculitis

Urticarial vasculitis is of allergic origin. Unlike regular allergies, symptoms do not go away immediately after you stop contact with the suspected allergen. This type of vasculitis is prone to chronicity.

Symptoms of urticarial vasculitis:

The main symptom of urticarial vasculitis is a rash. It resembles that of urticaria: red blisters appear on the skin.

Differences between urticaria rash and urticarial vasculitis:

Characteristic	Hives	Urticarial vasculitis
Blister density	Average	Very dense
How long does the rash last?	Short-term, quickly passes after cessation of contact with the allergen.	Lasts longer than 24 hours, usually 3 – 4 days.
Is there any itching?	Eat.	No, instead there is pain and burning.
What remains at the site of the rash after it disappears?	It passes without a trace.	Subcutaneous hemorrhages, green and yellow color, dark spots.
Does this affect the general condition of the patient?	Virtually no disruption. The main problems are related to itching.	It is disrupted and there is an increase in body temperature.
Are other organs affected?	Characteristic symptoms allergic reactions: Quincke's edema (swelling on the face); cough, shortness of breath, suffocation (due to swelling of the larynx and bronchi).	joint pain; indigestion; glomerulonephritis is an inflammatory process in the kidneys.

Diagnosis of urticarial vasculitis

Study	Description	How is it carried out?
General blood analysis	An acceleration of erythrocyte sedimentation is detected - a sign of an inflammatory process.	To perform a complete blood count, blood is usually taken from a finger or a vein.
Immunological studies	An increase in the concentration of antibodies and some other substances responsible for autoimmune inflammation is detected.	For testing, blood is usually taken from a vein.
General urine analysis	Finding blood and protein in the urine indicates kidney involvement.
Skin biopsy	Is the main, most informative method with urticarial vasculitis. This is the study of a fragment of a patient's skin under a microscope. Signs of inflammation and necrosis (tissue death) are detected.	The skin for examination is taken using a scraping, a needle, or a small fragment is cut off with a scalpel.

Treatment of urticarial vasculitis

Treatment of urticarial vasculitis is carried out according to the same principles as the treatment of all other allergic vasculitis (see “allergic vasculitis”, “hemorrhagic vasculitis”):

• if the specified medicines– glucocorticoids (drugs of adrenal hormones) and cytostatics (drugs that suppress the immune system).

Hemorrhagic vasculitis

Hemorrhagic vasculitis (Henoch-Schönlein disease) is a type of vasculitis that affects small vessels, followed by the skin, joints, and internal organs. The disease is most common in childhood and among young people.

Causes of hemorrhagic vasculitis

Hemorrhagic vasculitis is an autoimmune disease. Due to the excessive reaction of the immune system, a large number of immune complexes are formed in the blood. By settling on the walls of blood vessels from the inside, they lead to the development of inflammation.

Factors provoking the development of hemorrhagic vasculitis:

• angina– inflammation of the tonsils caused by streptococcal bacteria;
• exacerbation chronic inflammation tonsils(tonsillitis);
• pharyngitis– inflammation of the pharynx caused by infection;
• administration of certain vaccines and serums, to which the patient has intolerance;
• hypothermia.

Signs of hemorrhagic vasculitis

Group of symptoms	Description
General symptoms	increased body temperature; fever;
Skin lesions
Signs of joint damage (detected in 75% of patients)	Large joints are more often affected; there is pain and swelling; the intensity and duration of pain can vary greatly; impaired joint mobility (often associated with hemorrhage into the joint).
Signs of damage to internal organs	sharp stabbing or cramping pain in the abdomen; most often the pain is localized around the navel, sometimes in other parts of the abdomen; vomiting with blood; blood in the stool; with kidney damage - blood in the urine.

Diagnosis of hemorrhagic vasculitis

Study	What does it reveal?	How is it carried out?
General blood analysis	In a general blood test for hemorrhagic vasculitis, inflammatory changes are detected: increase in the number of leukocytes. The platelet count is within the normal range - this is a sign that the hemorrhages under the skin are not caused by a decrease in blood clotting.	For analysis, blood is taken from a finger or vein, usually in the morning.
Biochemical analysis blood	an increase in the amount of immune proteins - immunoglobulins; an increase in the content of fibrinogen, a protein responsible for blood clotting.	For analysis, blood is taken from a vein on an empty stomach.
Blood clotting test.	Specific analyzes and tests aimed at studying blood clotting. All indicators are normal, and this helps to prove that hemorrhages under the skin are not caused by bleeding disorders.	For analysis, blood is taken from a finger or vein.
Immunological studies	Determination of the content of antibodies, immune complexes, and some other substances in the blood that are responsible for the autoimmune inflammatory process.	For analysis, blood is taken from a vein.
Skin biopsy	Examination of a skin fragment under a microscope.	Allows you to accurately determine the pathological process occurring in the tissue.

Treatment of hemorrhagic vasculitis

A drug	Description	Mode of application
General treatment with hemorrhagic vasculitis
Askorutin	Combined vitamin preparation, a combination of ascorbic acid (vitamin C) and rutin (vitamin P). Both vitamins have a strengthening effect on the vascular wall, protect cells and tissues from oxidation by free radicals.	Release form: light green tablets, each containing 50 mg of rutin and ascorbic acid. Mode of application: Adults take 1 tablet after meals 1 – 2 times a day. The duration of the course is determined by the doctor individually.
Indomethacin	Anti-inflammatory drug. Suppresses the inflammatory process in blood vessels and eliminates the symptoms of the disease. Prescribed for long-term persistent hemorrhagic vasculitis.	Release forms: tablets of 0.025, 0.01 and 0.005 g; capsules of 0.05, 0.03 and 0.02 g. Mode of application: 150 – 200 mg of the drug per day. After the symptoms subside, the dose is reduced by half.
Hingamin (syn.: Delagil)	An antimalarial drug that can suppress the immune system.
Hydroxychloroquine (syn.: Plaquenil)	Analogue of Hingamin. Has an antibacterial effect and suppresses the immune system.	Taken as prescribed by a doctor.
In case of damage to the internal organs of the abdomen
Heparin	Heparin is an anticoagulant - it reduces blood clotting.	The dose of the drug is selected depending on the severity of the symptoms. Prescribed by a doctor in a hospital.
Fresh frozen plasma	Fresh frozen plasma is obtained from donors at blood transfusion centers. It contains natural organic matter, which normalize blood clotting and its other properties.	300–400 ml of plasma is administered intravenously. The procedure is carried out only in a hospital setting, for 3 to 4 days.
Curantil (syn.: Dipyridamole)	Effects: decreased blood clotting; protection of the walls of small vessels from damage; improvement of blood flow in small vessels.	Release form: Dragees and tablets of 25 and 75 mg. Mode of application: Take 75–225 g of the drug per day, dividing the total dose into several doses (as prescribed by your doctor). The tablets are taken on an empty stomach.
Trental (syn.: Pentoxifylline)	Effects: normalizes blood viscosity; dilates blood vessels; normalizes blood flow in organs and tissues.	Release forms: in tablets of 100 and 400 mg; in the form of a solution for injection in ampoules of 5 ml. Methods of application: In tablets: 1 tablet 3 times a day. In the form of injections: intravenously, in a dropper, dissolving the contents of two ampoules in 150 ml of saline solution.
For kidney damage
Delagil (syn.: chloroquine)	An antimalarial drug that has the ability to suppress immunity and autoimmune reactions.	Taken strictly as prescribed by a doctor.
Plaquenil	See above.	See above.

Periarteritis nodosa

Periarteritis nodosa is an allergic vasculitis in which small and medium-sized arteries are predominantly affected. Most often, the disease develops between the ages of 30 and 50 years. Men suffer 2–4 times more often than women.

Causes of periarteritis nodosa

Factors contributing to the development of this type of vasculitis:

• taking certain medications: antibiotics, painkillers, anti-tuberculosis, X-ray contrast agents;
• viral infections : hepatitis B, herpes, cytomegalovirus infection;
• genetic predisposition.

Processes occurring in the vessels during periarteritis nodosa:

• development of autoimmune inflammation in the vascular wall, as a result of which it is destroyed, grows and increases blood clotting;
• blocking the lumen of blood vessels, as a result of which the blood supply to organs is disrupted;
• vascular thrombosis;
• aneurysms(thinning of the wall) and ruptures of blood vessels;
• heart attacks(death of tissue as a result of cessation of blood circulation) in internal organs, after which atrophy and scarring develop, functions are disrupted.

Symptoms of periarteritis nodosa

Symptom	Explanation
Increased body temperature, fever	fever is usually the first symptom of the disease; is of an irregular nature: body temperature can rise and fall at any time of the day, without visible reasons; after taking antibiotics, body temperature does not decrease; The fever goes away as other symptoms occur.
Weight loss	very strongly expressed; Doctors often make mistakes and suspect a malignant tumor in a patient.
Pain in muscles and joints	most pronounced at the onset of the disease; The calf muscles and knee joints are most often affected.
Skin rashes	Types of skin rash with periarteritis nodosa: red spots; red spots and blisters; hemorrhages; bubbles; specific nodules along the vessels under the skin; areas of dead skin.
Damage to the cardiovascular system	angina pectoris(damage to blood vessels supplying the heart); myocardial infarction; arterial hypertension (increased blood pressure); heart failure; phlebitis(inflammation of the veins), which occurs periodically in different places; Raynaud's syndrome(damage to small vessels of the hands): attacks during which numbness of the fingers occurs, their pallor, the appearance of discomfort in the form of tingling, “crawling goosebumps”, pain.
Kidney damage	glomerulonephritis(as a result of impaired blood supply to the kidneys and their damage by immune complexes); renal vascular thrombosis– rare manifestation; renal failure– impaired renal function during a long course of the disease.
Nervous system lesions	mononeuritis– damage to any sufficiently large nerve due to disruption of its blood supply; polyneuritis– damage to a large number of small nerves due to disruption of the blood supply; seizures of the epileptic type.
Lung damage	pneumonitis – pneumonia, which, unlike pneumonia, is caused not by infection, but by an autoimmune process.
Damage to the abdominal organs	stomach ache; digestive disorders: bloating, feeling of heaviness, belching, etc.; blood in stool; enlarged liver, feeling of heaviness under the right rib; intestinal ulcers; signs reminiscent of pancreatic diseases: girdle pain in the upper abdomen, nausea, vomiting, digestive disorders after eating large amounts of fatty, fried foods.

What does periarteritis nodosa look like in the photo?

Erythema (red spots)
Maculopapular rash (red spots and blisters)
Hemorrhages (bleedings)
Vesicles (bubbles)
Specific nodules along the vessels under the skin.
Necrosis (areas of dead skin).

Diagnosis of periarteritis nodosa

Study title	Why is it carried out and what does it reveal?	How is it carried out?
General blood analysis	Helps identify the inflammatory process in the body: increased erythrocyte sedimentation rate; increased leukocyte count; increased content of eosinophils - “allergic” leukocytes; sometimes anemia is detected.	For the test, a small amount of blood is taken from a finger or a vein.
Blood chemistry	Helps identify the inflammatory process: disturbance of the protein composition of the blood: immunoglobulins (antibody proteins) begin to predominate; identification C-reactive protein, which is a characteristic marker of the inflammatory process.	For the study, a small amount of blood is taken from a vein in the morning on an empty stomach.
Research aimed at identifying pathological changes in internal organs.	Kidney damage: detection of protein and red blood cells in a general urine test. In case of heart damage: changes in the electrocardiogram, increase in heart size on x-rays, ultrasound. For severe muscle pain a biopsy is performed - taking a small amount muscle tissue for examination under a microscope.

Treatment of periarteritis nodosa

Drug name	Description and purpose of destination	Mode of application
Prednisolone (syn.: Prednisol, Prednihexal, Medopred)	A drug of the adrenal cortex hormone, which has a pronounced ability to suppress immune reactions and inflammation.	Release forms: For periarteritis nodosa, the drug is used in tablets of 0.005 g (respectively, 5 mg). Mode of application: The dosage of the drug is determined by the attending physician, depending on the activity of the process and the severity of symptoms. Treatment is carried out for 1 – 2 months. First, the maximum dose is prescribed, then it is reduced.
Cyclophosphamide (syn.: Cyclophosphamide, Cytoxan, Endoxan)	Belongs to the group of cytostatics. Suppresses the proliferation of lymphocytes - immune cells that produce antibodies. Thus, it suppresses immune reactions and eliminates autoimmune inflammation.	The drug is prescribed for fairly severe periarteritis nodosa. It is used in strictly defined dosages, exclusively as prescribed by a doctor. Accepted for 3 – 5 years.
Azathioprine (syn.: Imuran)	It is an immunosuppressant - suppresses the immune system, thereby eliminating autoimmune inflammation.	It is used in strictly defined dosages, exclusively as prescribed by a doctor.
Hemosorption and plasmapheresis	Hemosorption is a procedure during which blood is passed through special layers of sorbent outside the body. Plasmapheresis – purification of plasma using various methods: replacement with donor plasma; plasma purification in a centrifuge; plasma settling; passing blood plasma through a membrane that acts as a filter. Both procedures are aimed at cleansing the blood of immune complexes that cause vascular damage in periarteritis nodosa.	The plasmapheresis procedure lasts on average about 1.5 hours. The patient lies down in a special chair, and a needle connected to a machine is inserted into his vein. To effectively cleanse the blood, 3 to 5 procedures are usually required. Hemosorption is carried out under similar conditions, in rooms equipped like operating rooms. A needle connected to a machine is inserted into the vein. The blood is pumped using a pump through a special container filled with sorbent. On average, the procedure lasts 1–2 hours, during which time 6–9 liters of blood are purified.
Nicotinic acid (syn.: vitamin B3, niacin, vitamin PP)	Effects: dilation of small vessels and improvement of microcirculation; reducing the level of harmful fats in the blood; reducing blood cholesterol levels and slowing down the formation of cholesterol plaques. Nicotinic acid is used for periarteritis nodosa as a symptomatic remedy to improve blood circulation.	For periarteritis nodosa, tablets are used nicotinic acid 0.05 g each Mode of application: adults: ½ - 1 tablet 2 - 3 times a day; children: 1/5 - ½ tablets 2 - 3 times a day.
Parmidine (syn.: Prodectin)	Is an angioprotector - medicinal substance, which strengthens the vascular wall and protects it from damage.	Release form: tablets 0.25 g. Mode of application: 1 – 3 tablets 3 – 4 times a day. The course of treatment, as prescribed by a doctor, can last from 2 to 6 months.
Electrophoresis with novocaine on legs	Electrophoresis is a type of physiotherapy in which drugs are introduced into the body through the skin using electric current. Electrophoresis with novocaine is used to eliminate pain.	During the procedure, the doctor places on the skin lower limbs patient two electrodes wrapped in a cloth soaked in a drug solution. Then the device is adjusted so that the patient feels a slight tingling sensation. The procedure is usually carried out within 5 – 15 minutes. IN general course consists of 10 sessions.

Treatment of periarteritis nodosa includes mandatory correction of blood pressure. The patient is prescribed drugs that lower blood pressure and diuretics.

Nonspecific aortoarteritis (Takayasu disease)

Nonspecific aortoarteritis is a chronic disease in which an inflammatory process develops in the aorta and large vessels extending from it. Less commonly, the disease may involve the pulmonary arteries.

The disease, like other systemic vasculitis, is rare. Women get sick 3 to 8 times more often than men.

Causes of nonspecific aortoarteritis

The causes of the disease have not yet been fully elucidated. It is believed that two factors are involved in the development of nonspecific aortoarteritis:

• Autoimmune process. As with periarteritis nodosa, specific immune complexes are formed that cause damage to the vascular wall.
• Hereditary predisposition. The presence of certain genes increases the likelihood of developing the disease.

Manifestations of Takayasu's disease

Pathological changes in vessels with nonspecific aortoarteritis occurs in two stages:

• Initially, under the influence of immune cells, specific growths - granulomas - appear on the inner wall of the vessel.
• Subsequently, the inflammatory process gives way to scarring, and vascular sclerosis occurs.

Group of symptoms	Signs
Signs indicating the development of the inflammatory process. Usually occur at the very beginning of the disease, in young people (about 20 years old)	significant increase in body temperature, chills; increased fatigue, drowsiness; pain in joints and muscles.
Disruption of blood flow to the brain	dizziness; headache; tinnitus, “floaters before the eyes”; frequent fainting; general weakness, increased fatigue, drowsiness; absent-mindedness, impaired memory, attention, etc.; blurred vision, decreased acuity;
Increased blood pressure	Symptoms characteristic of arterial hypertension occur. When the abdominal part of the aorta and the renal vessels extending from it are damaged, the flow of blood and oxygen to the kidneys is disrupted. Pathological mechanisms are triggered, leading to an increase in blood pressure. If the aortic arch and the vessels extending to the upper extremities are affected, then different blood pressure readings are noted on the right and left arms.
Damage to the coronary (coronary) arteries, which arise from the aorta and carry blood to the heart muscle.	increased fatigue, weakness; symptoms of angina pectoris: periodic severe pain in the chest; increased risk heart attack.
Damage to the abdominal aorta and the vessels that extend from it to the abdominal organs.	periodic abdominal pain; bloating; indigestion.
Defeat pulmonary arteries, which carry venous blood to the lungs.	shortness of breath, rapid fatigue during physical work; chest pain; sometimes - a cough, during which sputum mixed with blood is released.

All the symptoms described occur with a large number of other diseases. Therefore, during a direct examination, it can be difficult for a doctor to establish an accurate diagnosis. It is confirmed only after a complex of laboratory and instrumental studies.

Diagnosis of nonspecific aortoarteritis

Diagnostic method	Description
Ultrasound examination of blood vessels	Using an ultrasound sensor, the doctor can visualize large vessels, determine the thickness of their lumen, and detect existing narrowings.
Dopplerography	Dopplerography is an addition to ultrasound examination, allowing one to assess the intensity of blood flow in the vessels and, thus, judge its disturbances.
Duplex scanning	Combination of Dopplerography with classical ultrasound examination. Allows you to create the most complete picture of the lumen of large vessels and the intensity of blood flow in them.
Rheovasography	The older method of studying blood flow in vessels has today been almost completely replaced by Dopplerography. The body is exposed to high frequency current and the electrical resistance of the blood vessels is measured. Based on the data obtained, blood flow is assessed.
Ultrasound examination of the heart and kidneys	Allows to identify disorders in these organs caused by damage to large vessels.
Angiography	A study during which a radiopaque substance is injected into the vessels, after which x-rays. Gives an idea of ​​the degree of blockage of the lumen of blood vessels. Kidney angiography is often performed - it gives an idea of ​​​​the degree of disruption of blood flow in them. Coronary angiography (angiography of the coronary arteries of the heart) helps identify narrowing sites in the coronary arteries.
General blood analysis	With nonspecific aortoarteritis, inflammatory changes are detected in a general blood test: increase in the number of leukocytes; acceleration of erythrocyte sedimentation.
General urine analysis	A general urine test for aortoarteritis helps identify signs of kidney damage: protein impurities in the urine; admixtures of red blood cells.

Treatment of nonspecific aortoarteritis

Medicine	Description	Mode of application
Prednisolone	A drug created on the basis of hormones of the adrenal cortex. Inhibits the reproduction and function of immune cells. Helps reduce antibody production. Due to this, it suppresses autoimmune processes leading to inflammation of the vascular wall in nonspecific aortoarteritis.	Prednisolone for long-term use is available in tablets. Dosages are prescribed exclusively by the attending physician, depending on the severity of the disease and the severity of symptoms. Prednisolone is taken in maximum dosages for 1 to 2 months. Then the dose is reduced and administration is continued for 1 to 2 years.
Azathioprine	Cytostatic. A powerful immune system suppressant.	It is used strictly as prescribed by a doctor, depending on the severity of the disease and the severity of symptoms. During the first month, the highest dose is prescribed. Then, throughout the year, a lower, supportive one.
Anti-inflammatory drugs: Diclofenac (Ortofen, Voltaren); Indomethacin.	Suppress the inflammatory process. Appointed when chronic course diseases.	Dosages and duration of therapy are strictly as prescribed by the doctor.
Drugs that reduce blood clotting: heparin; persantine; dipyridamole; pentoxifylline; chimes.	Prevents the formation of blood clots. Used for chronic disease.	Dosages and course duration are strictly as prescribed by the doctor.
Drugs that break up blood clots: streptokinase; urokinase; fibrinolysin.	These drugs dissolve blood clots that have already formed in the blood vessels.	They are used for complications associated with poor circulation in internal organs (heart, kidneys, etc.).

In case of nonspecific aortoarteritis, it is necessary to combat the increased blood pressure. The doctor must select medications for his patient, taking into account the fact that arterial hypertension is caused by poor circulation in the kidneys.

Surgical treatment of nonspecific aortoarteritis

Indications for surgical treatment nonspecific aortoarteritis:

• significant impairment of blood flow in the kidneys;
• significant circulatory impairment in the brain;
• poor circulation in the extremities, gangrene.

Usually a bypass operation is performed - the doctor replaces the affected area of ​​the vessel with one taken from another area of ​​the body or with an artificial implant.

Wegener's granulomatosis

Wegener's granulomatosis is a systemic vasculitis that affects the small vessels of the respiratory and kidney organs. The disease occurs in men and women with equal frequency. On average, its onset occurs at the age of 40 years.

Causes of Wegener's granulomatosis

The exact causes of this type of vascular vasculitis are not known.

Factors that play a role in its occurrence:

• various infectious diseases;
• autoimmune reactions.

Signs of Wegener's granulomatosis

Groups of symptoms for Wegener's granulomatosis:

• symptoms of upper respiratory tract damage;
• symptoms of lung damage;
• symptoms of kidney damage.

Types of Wegener's granulomatosis depending on the course of the disease:

• Local: the lesion affects only the upper respiratory tract.
• Limited: the lesion involves the upper respiratory tract and lungs. In this case, the kidney vessels are not affected.
• Generalized: damage to the lungs, upper respiratory tract and kidneys is noted.

Group of symptoms	Manifestations
Nasal lesion	feeling of dryness in the nose; difficulty breathing through the nose; nosebleeds
Purulent inflammation of the ear (otitis)	increased body temperature, fever; disturbance of general well-being; ear pain; Otitis media with Wegener's granulomatosis is often accompanied by joint pain.
Damage to the pharynx and larynx	dry cough; hoarse voice; sore throat.
Lung damage	increased body temperature; hacking cough; Sometimes when you cough, blood comes out.
Kidney damage	pain in the lumbar region; increased body temperature; a sharp decrease in the amount of urine.
Joint involvement (rare)	joint pain; swelling in the joint area; disturbances in joint movements.
Cardiac involvement (rare)	signs of myocarditis - inflammation of the heart muscle; signs of pericarditis - inflammation of the outer lining of the heart; pain behind the sternum, as with angina pectoris; myocardial infarction.
Damage to the digestive system (rare manifestation)	stomach ache; lack of appetite; bloody stool, black tarry stools; enlarged liver, heaviness under the right rib.

As you can see, the symptoms of Wegener's granulomatosis are very diverse and not always unambiguous. The disease occurs in different forms, and its course itself is also often different. Therefore, it is very difficult to suspect this pathology during an examination. Typically, a doctor thinks about Wegener's granulomatosis in the case when the patient has been suffering from a “cold” disease for a long time, which does not respond to conventional treatment, and protein is detected in a general urine test.

An accurate diagnosis is established after an examination.

Diagnosis of Wegener's granulomatosis

Type of study	Description
Rhinoscopy	Examination of the nasal cavity by an ENT doctor using a special instrument - a rhinoscope. The doctor examines the mucous membrane of the nasal cavity and assesses its condition.
Laryngoscopy	Examination of the larynx using a special device - a laryngoscope. It is carried out under anesthesia. The doctor examines the patient's laryngeal mucosa and assesses its condition.
Biopsy of the nasal mucosa	A fragment of the nasal mucosa is collected using special endoscopic equipment. The resulting material is then sent to the laboratory, where it is subjected to microscopy. A biopsy helps distinguish Wegener's granulomatosis from other nasal diseases, such as tumors, etc.
X-ray, X-ray tomography of the lungs	During x-ray examination a large number of small compactions are found in the lungs. Can reveal small cavities with walls.
Computed tomography, magnetic resonance imaging of the lungs	They are more accurate compared to radiography methods. They help clarify the data obtained during an x-ray examination.
Electrocardiography (ECG)	Used for signs of heart damage. During the study, it is revealed increased loads on the left ventricle, thickening of its wall.
Kidney ultrasound	During ultrasound examination the doctor evaluates the condition of the kidneys and their vessels. The test helps distinguish Wegener's granulomatosis from other kidney diseases.
Kidney biopsy	Taking a piece of kidney tissue for examination under a microscope. It is carried out using a needle that is inserted through the skin.
General blood analysis	: increased erythrocyte sedimentation rate; increase in the total number of leukocytes; an increase in the number of leukocytes of a special type responsible for allergic reactions - eosinophils; anemia, decreased hemoglobin content in the blood; an increase in the number of platelets, which indicates an increased tendency to form blood clots.
Blood chemistry	Signs of an autoimmune inflammatory process: violation of the ratio of blood proteins, increase in the relative amount of immunoglobulins - proteins that are antibodies; Most often, the content of immunoglobulins of class A, E, M increases. Detection of rheumatoid factor, a substance that is a marker of rheumatism and other autoimmune diseases.
General urine analysis	For kidney damage: detection of protein in urine; detection of a small number of red blood cells.

Treatment of Wegener's granulomatosis

Medicine	Description	Mode of application
Prednisolone	Hormonal drug(hormones of the adrenal cortex). It has a pronounced ability to suppress immune reactions, reproduction and functions of immune cells.	During the active phase of the disease, prednisolone is prescribed in maximum dosages. After 1.5 - 2 months, the dosage is reduced, the drug is continued to be taken for 1 - 2 years.
Cyclophosphamide	Cytostatic. Inhibits the reproduction and functions of immune cells.	It is prescribed according to a regimen similar to that of prednisolone. These two drugs are used together.
Azathioprine	Cytostatic. Inhibits the reproduction and function of immune cells. But weaker than cyclophosphamide in this regard.	Can be prescribed when the activity of the process decreases instead of cyclophosphamide.
Plasmapheresis and hemosorption	Special procedures aimed at cleansing the blood of immune complexes and toxins.	Prescribed if drug therapy for Wegener's granulomatosis has no effect.