Vasculitis

Vasculitis is a term for inflammation of the blood vessels. Since blood vessels exist in every part of your child’s body, inflammation can occur anywhere. There are several rare conditions that cause vasculitis, and each condition affects different parts of the body.

Vasculitis symptoms

When your child’s blood vessels are inflamed, it can cause different vasculitis symptoms. Sometimes vasculitis leads to blood clots or blocks the flow of blood through the affected vessels. In rare cases, vasculitis can cause an aneurysm – a bulging, weak spot in the wall of a blood vessel.

Symptoms of vasculitis that affect your child’s body more generally may include:

• Vasculitis rash
• Fever
• Weight loss
• Fatigue
• Pain
• Tingling or numbness

Vasculitis types

Vasculitis can be categorized based on the size of the blood vessels that are affected. Different symptoms go along with each vasculitis type.

• Large blood vessels: Headaches, joint pain and swelling, or stiff and painful hips and shoulders.
• Medium-sized blood vessels: Poor blood flow to hands and feet or inflammation of arteries in the heart.
• Small blood vessels: Muscle and joint pain, red dots on the legs, or effects on the kidneys and lungs.

What’s the most common type of pediatric vasculitis?

IgA vasculitis is the most common type of vasculitis in children. It usually affects those aged 3-10 years and affects mostly the small blood vessels in skin, joints, intestines and kidneys. Your child may have belly pain, kidney inflammation, or joint pain and swelling. IgA vasculitis is an autoimmune disorder where immunoglobulin A (IgA) antibodies mistakenly attack blood vessels and cause inflammation.

IgA vasculitis often occurs after a gastrointestinal or upper respiratory infection. Insect bites are another possible trigger for IgA vasculitis as well as reactions to foods, some vaccinations or certain medicines.

Other conditions that cause vasculitis in children are:

• Behçet’s syndrome
• Granulomatosis with polyangiitis (GPA)
• Kawasaki disease
• Polyarteritis nodosa
• Takayasu arteritis (TAK)

Prevention of vasculitis

It’s important to avoid infections, so your child’s doctor may recommend vaccinations when possible. Vaccinations for flu, pneumonia, shingles and COVID can prevent these infections or ensure your child has a less serious illness.

Diagnosis of vasculitis

To diagnose vasculitis, your child’s doctor will gather a medical history, perform a physical exam and ask about potential vasculitis symptoms. They’ll run blood and urine tests and order imaging tests such as X-rays, MRI or CT scans

If vasculitis appears to be affecting your child’s heart or kidneys, their doctor may recommend taking a biopsy to look for signs of inflammation or damage. Biopsies of the skin may also be recommended if your child has a skin condition that may be related to vasculitis.

Vasculitis treatment

Vasculitis in children often resolves on its own. When treatment is recommended, it will consist of easing any symptoms. Your child’s doctor may suggest over-the-counter pain medications or prescribe anti-inflammatory medications.

If your child has kidney disease associated with vasculitis, they may receive prednisone or a medication to suppress their immune system. Such medications are monitored closely to avoid serious side effects.

Since different vasculitis types can affect different parts of the body, your child’s treatment may be planned by a team of specialists including a primary care doctor, dermatologist, cardiologist, gastroenterologist, rheumatologist, infectious disease specialist, or others as needed.