Vasculitis often occur against the backdrop of some other disease. In this case they are called secondary and regress at treating the underlying disease. Treatment is the same system vasculitis - is one of the most serious problems of our time. However, if the time to identify the disease and begin treatment, then it can handle.

Treatment always begins with vasculitis diagnostics

Conduct a full examination of the patient, the goal is not only to establish the correct diagnosis, but also to identify all possible lesions of the internal organs. In addition, the patient examined and to identify foci of chronic infection that can cause the disease and will maintain it constantly, causing aggravation.

Only after the establishment of the correct diagnosis can begin full treatment.

General principles of treatment of systemic vasculitis

The basis of systemic vasculitis (inflammation of blood vessel walls) are infectious, allergic and autoimmune (allergic to its own tissues) processes. Such a process requires a powerful anti-inflammatory treatment with simultaneous suppression of immunity Immunity - types and characteristics in children in adults .

Furthermore, in the blood of patients with systemic vasculitis are circulating immune complexes, which have a very destructive effect on blood vessels. In the treatment of these complexes are removed from the blood.

For the treatment and recovery of function of individual organs used a variety of treatments with the assistance of specialists in various fields.

The objective of treatment - active suppression of the inflammatory process, followed by a systematic maintenance therapy.

The initial phase of treatment - Transfer of the disease into remission

The patient is required to be appointed hypoallergenic diet Hypoallergenic diet - the salvation for the stomach   and also held a short but intensive course of anti-inflammatory and immunosuppressive treatment.

Anti-inflammatory treatment of systemic vasculitis performed mainly using glucocorticoid hormones. They very quickly eliminate the inflammation in the blood vessel walls. In addition, glucocorticoids suppress the immune processes, not least in the vasculitis.

Today, anti-inflammatory treatment is also carried out with intravenous immunoglobulin. The mechanism of action of immunoglobulins in this case is not entirely clear, but the effectiveness of the treatment when it is used considerably increases.

To suppress the activity of the immune system The immune system - how it works?   glucocorticoids alone is sometimes not enough. Then administered cytostatics (cyclophosphamide, methotrexate, azathioprine). With these drugs in combination with glucocorticoids can reliably suppress inflammation and to prevent possible relapses.

To remission occurred as early as possible is carried out by the cleansing blood of immune complexes of antigen - antibody and other harmful substances by means of plasmapheresis.

Supportive care

After an intensive course of treatment is supportive therapy. For this purpose, administered cytostatics for extended periods - from six months to two years. The preparation for such therapy and the dose the doctor selects individually, it should be sufficient to maintain a state of remission. The effectiveness of treatment is constantly monitored by a doctor and confirmed by laboratory tests (absence of signs of inflammation in the blood count).

At the same time the patient is under constant medical supervision and in the case of recurrence of the disease he will be assigned to complex treatment.

Today, techniques developed systemic vasculitis immune therapy using antibodies to a wide range of tissue antigens.

Rehabilitation treatment

Systemic vasculitis cause significant damage to various organs and tissues. In a preliminary survey of all these violations are identified, and further function of the organs by means of various methods of treatment, including with the involvement of different specialists, fully or partially restored.

For this purpose, the drugs reducing the circulation of blood, strengthen the walls of blood vessels, thrombus formation preventive and so on. At the same time chronic foci of infection being treated.

Treatment of systemic vasculitis - a large and complex problem that requires a doctor's knowledge and experience, and from the patient - strict compliance with all recommendations of the physician. But even if all these conditions are fully cure systemic vasculitis Vasculitis - when blood vessels refuse to work   It is not always possible. In most cases, using such treatment is only possible to achieve stable remission of the disease.

Galina Romanenko

Cryoglobulinemic vasculitis 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.

Galina Romanenko