Vasculitis - when blood vessels refuse to work
- It is one of the most unexplored types of vasculitis, which is characterized by severe progressive course. The main thing with this disease - its timely detection and adequate treatment. Vasculitis must be taken seriously, especially on the part of the patient, which must strictly comply with all the prescribing physician.
What cryoglobulinemic vasculitis and the reasons for its development
This is a condition where there are special blood proteins cryoglobulins - immunoglobulins precipitated at a temperature below 37 ° C, and tend to dissolve under heating. As a result of the precipitation reaction cryoglobulins deposited on the walls of capillaries, destroying them. Immunological precipitation reaction is an interaction between the antigen and the antibody to form insoluble immune complexes.
The body produces antibodies to the foreign agent (e.g., infectious agents, foreign proteins etc.), which are called antigens. Normally, antigen-antibody complexes are excreted without causing damage. When cryoglobulinemic vasculitis they cause damage to the capillaries in various organs and tissues.
Antigens in this disease may be different viruses and bacteria, but in most cases this is the hepatitis C virus or proteins that make up its core. Why is this so unknown. Moreover, it was found that a small amount of cryoglobulins present in the blood of many people without causing vasculitis. Conversely may show signs of vasculitis cryoglobulinemic without a corresponding complexes in the blood. This makes the disease even more mysterious.
Cryoglobulinemic vasculitis may be independent primary systemic disease (less common than secondary, and its causes are still unknown) and can be secondary to developing on the background of some of the underlying disease - hepatitis C (the vast majority of cases), another infection or collagenosis .
The main symptoms of the disease
Signs cryoglobulinemic vasculitis may be different. The most characteristic symptoms (Meltzer triad) are the cutaneous manifestations, joint pain
Joint pain - how to understand what is going on?
and marked weakness.
The skin often first appear sensory disturbances, and then a purple rash - a rash non-vanishing at a pressure in the form of multiple small hemorrhages in the skin. Develops this trait because of the defeat of the small veins. Purpura occurs mainly on the skin of the lower limbs, it can not only see but also feel out of elevation above the dense skin. After a rash passes, the body are brown spots - the remnants of the destroyed red blood cells in the form of hemosiderin.
Less rash resolved necrosis (tissue death), and the formation of ulcers. Sometimes, there are signs of circulatory disorders of the tips of fingers, toes, ears and nose - Raynaud's syndrome. Such violations lead to tissue necrosis, gangrene or ulcers appearance.
Pain in the joints (arthralgia) almost always occur in this type of vasculitis. Interestingly, the pain occurs, in large (hip, knee ankle) and very small joints (joints of the fingers and toes). When supercooling joint pain worse. Sometimes developing joint inflammation - arthritis
Arthritis - a variety of forms and complications
. Quite often there, and muscle aches.
Also affects the peripheral nerves, often it manifests itself in the form of sensory disturbances. Movement disorders are rare. Sometimes, the process involved the small arteries of the brain that can cause disorders of speech and motor paralysis.
Quite often affects internal organs - lungs, kidneys, liver, gastrointestinal tract, spleen. If it affects the lungs sometimes develops shortness of breath and cough. Renal disease can be severe glomerulonephritis with a rise in blood pressure, blood and large amounts of protein in the urine. Occasionally the disease complicated by acute renal failure. With the defeat of the mesenteric vessels (ligament, which is suspended from the intestine) appear severe abdominal pain
Abdominal pain: Types and Symptoms
. If it affects the liver and spleen, there is an increase of those bodies.
Diagnosis and treatment
Diagnosis of the disease is carried out according to the survey and inspection of the patient and confirmed by laboratory immunological studies - the presence in the blood of a large number of cryoglobulins. There are also study histological tissue taken by biopsy. Be sure to study blood for hepatitis C and other viral and bacterial infections. To detect changes in the internal organs using ultrasound, x-ray, CT and MRI.
Treatment of the disease is carried out by various methods. In order to cleanse the blood of the patients underwent plasmapheresis cryoglobulins. In order to reduce inflammation in vessel walls and immunosuppression administered glucocorticoid hormones. If the disease is very severe, then added cytotoxic agents - drugs that significantly inhibit the immune system. If you have hepatitis C patient is prescribed antiviral drugs.
Completely impossible to cure this disease. But the right treatment based on the reasons for the onset of disease (if it is possible to reveal), and the individual characteristics of the patient is able to suppress the development of disease exacerbation and significantly reduce the risk of exacerbations.