Vasculitis

If your child’s immune (disease-fighting) system attacks their blood vessels, they can get a rare condition called vasculitis [vas-kyuh-LIE-tis] which causes the blood vessels to get inflamed.

When a blood vessel is inflamed, it may start to close, keeping blood from travelling through the vessel. If this happens, your child’s organs can be damaged because they don’t get enough blood.

Sometimes the blood vessel will get stretched out, weakening it. This leads to a bulge called an aneurysm ANN-yer-IZ-uhm]. This is a rare complication.

Vasculitis can happen because of an infection or a bad reaction to medicine, or it might be a sign of another medical problem. Sometimes the reason for it is not known.

Because blood vessels are found through the body, vasculitis can happen anywhere. It might affect many places at once, or it might only affect a single area.

Many cases of vasculitis are mild and need little treatment or no treatment at all, but if the hurt blood vessels are in or near a vital organ, vasculitis can be very serious. For example, vasculitis in the kidneys can lead to kidney failure.

The many types of vasculitis are mainly organized by the size of the blood vessels affected. These are the 2 most common types in kids:

• Henoch-Schonlein purpura [HEN-awk SHURN-lahyn PUR-pyoo-ruh] (HSP) happens most of the time in kids age 2 to 6. HSP affects small blood vessels in the skin. It is marked by a purple rash usually on the legs, feet, and butt.
• Kawasaki [KAH-wah-SAH-kee] disease is a rare childhood disease that affects the whole body and blood vessels of any size. It is marked by a high fever, red eyes, and a rash.

A less common type of vasculitis in kids is granulomatosis [GRAHN-yoo-low-muh-TOH-sis] with polyangiitis [PAH-lee-an-jee-AHY-tis] (GPA). It used to be called Wegener’s granulomatosis or Wegener’s disease. It affects the skin, kidneys, and lungs. 

Symptoms of vasculitis are similar to those of a cold or flu, including:

• Fever
• Sore throat
• Cough
• Random aches and pains
• Upset stomach
• Being tired
• Not being hungry
• Losing weight

Your child might feel some or all of these signs of inflammation in the affected area:

• Pain
• Redness
• Swelling
• Warmth

If your child’s skin is affected, they may get a rash. If their mouth is affected, they might have a painful sore. Some kinds of vasculitis affect the joints, making them swollen and sore.

Sometimes, your child’s body part that is hurt might feel weird. After that feeling goes away, that part might be very weak, or your child might not be able to move it.

You should take your child to the doctor

• If they feel sick and their symptoms won’t go away
• If they have unusual symptoms

Other signs that your child’s doctor should check as soon as possible include

• Rashes
• Bruises with no known causes
• Swelling
• A cough with blood
• Swollen lymph nodes in the neck

Vasculitis happens when your child’s immune system attacks the blood vessels. This makes the blood vessels irritated and inflamed. When that happens, the blood vessels start to close so blood can’t travel through the area like it should.

Sometimes the blood vessels close all the way. When body parts do not get the blood they need, they will start to shut down.

Doctors don’t know why vasculitis happens, but some cases have been linked to infections, bad reactions to medicine, or autoimmune disease such as lupus [LOO-puhs].

HSP may run in families. It has been linked to bug bites, getting too cold, and having strep throat.

Because vasculitis can occur in many different places in the body, causing many different symptoms, it can be hard to diagnose. Your child’s doctor will do an exam, ask about your child’s symptoms, and order tests.

The first test done is usually a blood test. This can show if your child’s red blood cell count is low, which can be a sign of vasculitis. Another common test is a urinalysis..

There are many other tests that can be done to tell if your child has vasculitis. Some of these tests include

• Biopsy [BY-op-see]. To check for inflammation in the sample that the doctor removed from your child’s body.
• X-ray. To check your child’s lungs and large blood vessels called arteries [AHR-tuh-reez].
• CT scan. To show more detail than what is seen in an x-ray.
• Angiography [ANN-jee-AW-gruh-FEE]. Combining a dye and x-rays to show how blood flows through your child’s blood vessels.

Treatment for vasculitis will depend on the kind it is and where it is happening. Starting treatment as soon as possible can help to slow or maybe prevent complications.

Some cases of vasculitis like HSP are mild, and they may not need treatment beyond self-care that you can do at home (rest, fluids, over-the-counter pain relievers).

Medical treatment will focus on stopping the immune system problem that is making it attack the blood vessels. This often begins with a kind of medicine called a corticosteroid [cor-tih-co-STARE-oyd]. This kind of medicine will help with inflammation.

If this does not work or your child’s vasculitis is severe, your child’s doctor might try a cytotoxic medicine. This will kill the inflamed cells, but it has worse side effects. Chemotherapy in low doses might also be used.

Other medicines might be used for specific kinds of vasculitis. For Kawasaki disease, kids are treated with immune globulin that is given through a vein.

Some cases involve vital organs of the body such as the brain, the kidneys, and the lungs. These organs might require special treatment. For example, when vasculitis affects the kidneys, your child might need dialysis [dahy-AL-uh-sis]. This is a procedure that cleans your child’s blood because the kidneys can’t do it.

Surgery is a rare treatment for vasculitis. It might be needed to remove aneurysms that sometimes form.

Vasculitis can’t be prevented or cured. Treatment can help to prevent or slow the complications that it causes.

Vasculitis seems to happen more often in people who smoke. Not being around second-hand smoke may help your child avoid vasculitis and other problems.

• National Heart, Lung, and Blood Institute
• MedlinePlus
• HealthyChildren.org

Vasculitis [VAS-kyuh-LIE-tis] is a rare condition that happens when the body’s immune (disease-fighting) system attacks the blood vessels, causing them to become inflamed. An inflamed blood vessel will start to close and blood won’t be able to travel through the vessel. Not having blood flow can damage your child’s organs. Vasculitis can happen anywhere in the body where there are blood vessels. It can be mild or very serious. Treatment focuses on stopping the immune system response that is the cause.