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What is Lupus Vasculitis?

Jim B.
Jim B.

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

Vasculitis generally stems from a process that begins when antigens cause an allergic reaction in the blood vessel walls. Antibodies are then created, which bond to the antigen, thereby attracting white blood cells to the afflicted area to destroy the antigen. In this form of lupus, these white blood cells then accumulate in the vessel walls, causing blood vessel inflammation.

A diagram showing the composition of a blood vessel. Vasculitis means that the blood vessels are inflamed.
A diagram showing the composition of a blood vessel. Vasculitis means that the blood vessels are inflamed.

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

Blood tests that count the number of white and red blood cells help determine a diagnosis of lupus vasculitis.
Blood tests that count the number of white and red blood cells help determine a diagnosis of lupus vasculitis.

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

A CAT scan may be necessary to diagnose lupus vasculitis.
A CAT scan may be necessary to diagnose lupus vasculitis.

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

A diagnosis of lupus vasculitis is often confirmed by a tissue biopsy.
A diagnosis of lupus vasculitis is often confirmed by a tissue biopsy.

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

Discussion Comments

burcinc

@turquoise-- I'm not a doctor so please don't quote me on this. This is just my opinion.

If the spots are slightly purplish, it's probably vasculitis but don't worry. This type of vasculitis is not serious and can be treated with blood thinning medications. It's internal vasculitis that we need to worry about since this type can cause serious damage to organs and blood clots that are very risky.

Also, there are more than one types of lupus. There is cutaneous lupus which affects skin and systemic lupus which can affect the skin and other organs. I think if you have the former, vasculitis is less likely or less dangerous. And many people with lupus experience vasculitis at some point so it's not rare either. So don't panic.

bear78

@turquoise-- I don't think that it's a good idea to jump to conclusions and to try to diagnose yourself. Red spots are a symptom of vasculitis but you need to see a doctor. A physical exam in addition to diagnostic testing needs to take place for a diagnosis. Remember that lupus can also cause skin rashes. It's possible to mistake a mild skin rash with vasculitis. These rashes can look a little different in different people. So talk to your doctor about your symptoms. Whatever it is, your doctor will give you the most accurate information about it.

turquoise

I have lupus and have recently developed redness on certain areas of my skin. The redness is not painful and it's not going away. Are these lupus vasculitis symptoms?

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    • A diagram showing the composition of a blood vessel. Vasculitis means that the blood vessels are inflamed.
      By: Balint Radu
      A diagram showing the composition of a blood vessel. Vasculitis means that the blood vessels are inflamed.
    • Blood tests that count the number of white and red blood cells help determine a diagnosis of lupus vasculitis.
      By: mystock
      Blood tests that count the number of white and red blood cells help determine a diagnosis of lupus vasculitis.
    • A CAT scan may be necessary to diagnose lupus vasculitis.
      By: Andrey Ushakov
      A CAT scan may be necessary to diagnose lupus vasculitis.
    • A diagnosis of lupus vasculitis is often confirmed by a tissue biopsy.
      By: luchschen_shutter
      A diagnosis of lupus vasculitis is often confirmed by a tissue biopsy.
    • Individuals suffering from lupus may have an increased risk of developing lung cancer.
      By: Andres Rodriguez
      Individuals suffering from lupus may have an increased risk of developing lung cancer.
    • If vasculitis affects tissues near the brain it can cause headaches and other serious complications.
      By: Imcsike
      If vasculitis affects tissues near the brain it can cause headaches and other serious complications.
    • Hydrotherapy may be used to treat the achy joints associated with lupus.
      By: Photographee.eu
      Hydrotherapy may be used to treat the achy joints associated with lupus.