10 Common Vasculitis Symptoms You Should Never Ignore

Vasculitis is a complex inflammatory condition that affects blood vessels throughout the body, causing them to become inflamed, narrowed, or weakened. This inflammation can restrict blood flow and damage vital organs and tissues. Understanding the symptoms of vasculitis is crucial for early detection and proper medical intervention, as this condition can range from mild to life-threatening depending on which blood vessels are affected.

The symptoms of vasculitis vary widely depending on the type of vasculitis, which blood vessels are involved, and which organs are affected. Some people may experience only mild symptoms, while others may develop serious complications affecting the kidneys, lungs, heart, or nervous system. Recognizing these warning signs early can make a significant difference in treatment outcomes.

1. Skin Rash and Discoloration

One of the most visible and common symptoms of vasculitis is a distinctive skin rash. The vasculitis rash typically appears as red or purple spots (purpura) or raised bumps on the skin, most commonly on the legs, feet, and buttocks. These spots occur when inflamed blood vessels near the skin surface leak blood into surrounding tissues.

The rash may present in various forms:

• Purpura: Purple or red spots that don’t blanch (turn white) when pressed
• Petechiae: Tiny pinpoint red dots on the skin
• Urticaria: Raised, itchy welts similar to hives
• Livedo reticularis: A mottled, lace-like pattern on the skin

The rash may be painful, itchy, or burning. In some cases, skin ulcers or open sores may develop, particularly in severe cases. The appearance and location of the rash can help doctors determine which type of vasculitis is present.

2. Persistent Fever

Many people with vasculitis experience unexplained fever that persists for days or weeks. This fever occurs as the body’s immune system responds to the inflammation in the blood vessels. The temperature may fluctuate throughout the day, sometimes accompanied by chills and night sweats.

The fever associated with vasculitis is typically low-grade to moderate, ranging from 99°F to 102°F (37.2°C to 38.9°C), though it can occasionally be higher. Unlike fevers from common infections, vasculitis fever often doesn’t respond well to over-the-counter fever reducers and may persist despite treatment. This persistent, unexplained fever, especially when combined with other symptoms, warrants medical evaluation.

3. Extreme Fatigue and Weakness

Overwhelming fatigue is one of the most debilitating symptoms of vasculitis. This isn’t the normal tiredness from a busy day—it’s a profound exhaustion that doesn’t improve with rest and can significantly impact daily activities. The fatigue results from the body’s immune system working overtime to fight inflammation, as well as reduced blood flow to tissues and organs.

Patients often describe this fatigue as:

• Feeling completely drained of energy
• Difficulty getting out of bed in the morning
• Inability to complete normal daily tasks
• Need for frequent naps or rest periods
• Mental fog or difficulty concentrating

This chronic fatigue can persist for months and may be one of the last symptoms to improve even after treatment begins.

4. Joint and Muscle Pain

Arthralgia (joint pain) and myalgia (muscle pain) are common manifestations of vasculitis. The pain typically affects multiple joints symmetrically, most often the knees, ankles, wrists, and hands. Unlike arthritis, the joints usually aren’t permanently damaged, though they may be swollen, tender, and stiff, particularly in the morning.

Muscle pain in vasculitis can range from mild aching to severe cramping and tenderness. The muscles may feel weak, making it difficult to climb stairs, lift objects, or perform routine activities. Some patients experience muscle tenderness when touched or pressed. The pain may migrate from one area to another and can be accompanied by muscle inflammation (myositis) in more severe cases.

5. Nerve Damage (Peripheral Neuropathy)

When vasculitis affects the blood vessels supplying the nerves, it can cause peripheral neuropathy—damage to the peripheral nervous system. This occurs because inflamed vessels restrict blood flow to the nerves, depriving them of oxygen and nutrients they need to function properly.

Symptoms of nerve involvement include:

• Numbness and tingling: Often starting in the toes or fingers and progressing upward
• Burning sensations: Particularly in the feet and hands
• Shooting or stabbing pains: Sharp, electric-like pain along nerve pathways
• Weakness: Difficulty gripping objects or foot drop when walking
• Loss of coordination: Clumsiness or balance problems
• Sensitivity to touch: Normal touch may feel painful

Nerve damage can be one of the more serious complications of vasculitis and may require prompt medical attention to prevent permanent damage.

6. Respiratory Problems

Vasculitis can affect the lungs and respiratory tract, leading to various breathing difficulties. When blood vessels in the lungs become inflamed, it can cause shortness of breath, chronic cough, and chest pain. Some patients cough up blood (hemoptysis), which is a serious symptom requiring immediate medical attention.

Respiratory symptoms may include:

• Persistent dry or productive cough
• Wheezing or whistling sounds when breathing
• Shortness of breath during normal activities or at rest
• Chest tightness or pain, especially when breathing deeply
• Nasal congestion, nosebleeds, or sinus problems

In severe cases, vasculitis can cause pulmonary hemorrhage (bleeding in the lungs) or pulmonary infiltrates, both of which are medical emergencies requiring immediate intervention.

7. Kidney Problems

The kidneys are frequently affected by vasculitis, though symptoms may not be immediately apparent. Kidney involvement can be particularly serious as it may progress silently without obvious symptoms until significant damage has occurred. The inflammation of blood vessels in the kidneys impairs their ability to filter waste and maintain fluid balance.

Signs of kidney involvement include:

• Blood in urine: Urine may appear pink, red, or cola-colored
• Protein in urine: Causing foamy or bubbly appearance
• Decreased urine output: Urinating less frequently or in smaller amounts
• Swelling: Particularly in the legs, ankles, feet, and around the eyes
• High blood pressure: Often discovered during routine checks

Because kidney damage can occur without obvious symptoms, regular urine and blood tests are important for anyone diagnosed with or suspected of having vasculitis.

8. Digestive System Issues

When vasculitis affects blood vessels in the digestive tract, it can cause a range of gastrointestinal symptoms. The reduced blood flow to the intestines can lead to inflammation, ulcers, or in severe cases, perforation of the intestinal wall.

Digestive symptoms may include:

• Abdominal pain: Often cramping or colicky, may worsen after eating
• Nausea and vomiting: Sometimes with blood
• Diarrhea: May contain blood or appear black and tarry
• Loss of appetite: Leading to unintended weight loss
• Bloating and distension: Feeling of fullness or swelling in the abdomen

Severe abdominal pain, especially when accompanied by bloody stools or vomiting blood, requires immediate medical evaluation as it may indicate serious complications such as bowel perforation or intestinal bleeding.

9. Eye Problems

Vasculitis can affect blood vessels in and around the eyes, potentially leading to vision problems ranging from mild irritation to severe vision loss. The inflammation can affect various parts of the eye, including the conjunctiva, sclera, retina, and optic nerve.

Eye-related symptoms include:

• Red, painful eyes: Inflammation of the white part of the eye (scleritis or episcleritis)
• Blurred vision: Difficulty focusing or seeing clearly
• Double vision: Seeing two images of a single object
• Light sensitivity: Discomfort or pain when exposed to bright light
• Eye pain: Deep, boring pain that may worsen with eye movement
• Vision loss: Partial or complete loss of vision in one or both eyes

Any sudden changes in vision or severe eye pain should be treated as a medical emergency, as delayed treatment can result in permanent vision loss.

10. Headaches and Neurological Symptoms

When vasculitis affects blood vessels in the brain or central nervous system, it can cause serious neurological symptoms. These symptoms occur when inflamed vessels restrict blood flow to the brain or when the inflammation affects the vessel walls themselves.

Neurological manifestations include:

• Severe headaches: Often described as the worst headache ever experienced, particularly in temporal arteritis
• Confusion or difficulty thinking: Mental fog, memory problems, or difficulty concentrating
• Seizures: New-onset seizures without prior history
• Stroke-like symptoms: Sudden weakness, numbness, or difficulty speaking
• Dizziness or vertigo: Feeling of spinning or loss of balance
• Jaw pain: Pain when chewing (jaw claudication), especially in giant cell arteritis

Central nervous system involvement is particularly serious and requires urgent medical attention. Any sudden neurological symptoms such as severe headache, confusion, seizures, or stroke-like symptoms should be treated as a medical emergency.

Main Causes of Vasculitis

While the exact cause of vasculitis isn’t always clear, several factors can trigger or contribute to the development of this condition:

Autoimmune Disorders: In most cases of vasculitis, the immune system mistakenly attacks the body’s own blood vessels. This autoimmune response causes inflammation and damage to vessel walls. Conditions like rheumatoid arthritis, lupus, and Sjögren’s syndrome can be associated with vasculitis.

Infections: Certain bacterial, viral, and fungal infections can trigger vasculitis. Hepatitis B and C viruses are particularly associated with vasculitis development. The infection may directly affect blood vessel walls or trigger an abnormal immune response that leads to vessel inflammation.

Medications and Drugs: Some medications can cause vasculitis as an adverse reaction. Antibiotics, blood pressure medications, and certain illegal drugs can trigger this condition. Drug-induced vasculitis typically resolves once the offending medication is discontinued.

Genetic Factors: While vasculitis isn’t directly inherited, genetic predisposition may play a role in some types. Certain genetic markers are more common in people with specific forms of vasculitis, suggesting a hereditary component to susceptibility.

Blood Cell Cancers: Conditions affecting blood cells, such as leukemia and lymphoma, can sometimes trigger vasculitis. The abnormal immune response associated with these cancers may contribute to blood vessel inflammation.

Allergic Reactions: Severe allergic reactions to medications, chemicals, or other substances can sometimes lead to vasculitis. This type is often limited to the skin and may resolve once the allergen is removed.

Unknown Factors: In many cases, particularly in primary vasculitis, no specific trigger or cause can be identified. These cases are considered idiopathic, meaning they arise spontaneously without a known cause.

Prevention Strategies

While many forms of vasculitis cannot be completely prevented due to their autoimmune or unknown origins, certain strategies may help reduce risk or prevent flare-ups:

Infection Prevention: Since infections can trigger vasculitis, practicing good hygiene and staying up to date with vaccinations may help reduce risk. This includes regular handwashing, avoiding contact with sick individuals when possible, and getting vaccinated against hepatitis B and other preventable infections.

Medication Management: If you’ve experienced drug-induced vasculitis, maintaining a detailed record of medications that caused reactions and informing all healthcare providers is crucial. Avoid medications known to trigger vasculitis in susceptible individuals.

Managing Underlying Conditions: If you have an autoimmune disease or chronic condition, working with your healthcare provider to keep it well-controlled may help reduce the risk of developing vasculitis. This includes taking medications as prescribed and attending regular follow-up appointments.

Healthy Lifestyle Choices: While not directly preventive, maintaining a healthy lifestyle can support overall immune function. This includes eating a balanced diet, getting regular exercise, managing stress, avoiding smoking, and limiting alcohol consumption.

Regular Medical Monitoring: If you have risk factors for vasculitis or a history of the condition, regular check-ups with your healthcare provider can help detect early signs of disease activity. This allows for prompt intervention before serious complications develop.

Avoiding Triggers: If you know specific triggers that cause vasculitis flare-ups, such as certain environmental factors, foods, or stressors, avoiding these triggers when possible may help prevent recurrence.

Frequently Asked Questions

What is vasculitis?

Vasculitis is an inflammatory condition that causes the blood vessels to become inflamed, which can restrict blood flow and damage organs and tissues. It can affect blood vessels of any size, from small capillaries to large arteries, throughout the body.

Is vasculitis contagious?

No, vasculitis is not contagious. You cannot catch it from or spread it to another person. While infections can sometimes trigger vasculitis, the condition itself is an inflammatory or autoimmune disorder, not an infectious disease.

How is vasculitis diagnosed?

Diagnosis typically involves a combination of physical examination, blood tests, urine tests, imaging studies (such as X-rays, CT scans, or MRI), and often a biopsy of affected tissue or blood vessels. The specific tests depend on which organs are suspected to be involved.

Can vasculitis go away on its own?

Some mild forms of vasculitis, particularly those triggered by medications or minor infections, may resolve on their own once the trigger is removed. However, most forms of vasculitis require medical treatment to control inflammation and prevent organ damage. Never assume vasculitis will resolve without evaluation by a healthcare provider.

Is vasculitis life-threatening?

The severity of vasculitis varies greatly. Some forms are mild and affect only the skin, while others can be life-threatening if they affect vital organs like the kidneys, lungs, heart, or brain. Early diagnosis and appropriate treatment significantly improve outcomes and reduce the risk of serious complications.

Who is at risk for developing vasculitis?

Vasculitis can affect people of any age, gender, or ethnicity, though certain types are more common in specific groups. Risk factors include having an autoimmune disease, certain infections (particularly hepatitis B or C), taking certain medications, and having a family history of vasculitis. Some types are more common in specific age groups or ethnic backgrounds.

How long does vasculitis last?

The duration varies depending on the type of vasculitis and individual factors. Some forms are acute and resolve within weeks to months with treatment, while others are chronic conditions that require long-term management with periods of remission and flare-ups.

When should I see a doctor about vasculitis symptoms?

You should seek medical attention if you experience persistent unexplained rash, prolonged fever, severe fatigue, joint pain, numbness or tingling in extremities, difficulty breathing, blood in urine, or any other concerning symptoms mentioned in this article. Sudden severe symptoms like vision changes, severe headache, stroke-like symptoms, or coughing up blood require immediate emergency care.

Can stress trigger vasculitis?

While stress alone doesn’t directly cause vasculitis, it may contribute to flare-ups in people who already have the condition. Stress can affect immune system function and inflammation levels in the body. Managing stress through relaxation techniques, exercise, and adequate sleep may help reduce the frequency or severity of flare-ups.

Are there different types of vasculitis?

Yes, there are many different types of vasculitis, classified based on the size of blood vessels affected and the specific organs involved. These include giant cell arteritis, Takayasu arteritis, polyarteritis nodosa, Kawasaki disease, Behçet’s disease, Henoch-Schönlein purpura, and granulomatosis with polyangiitis, among others. Each type has specific characteristics and may affect different age groups.

References:

• Mayo Clinic – Vasculitis
• Johns Hopkins Medicine – Vasculitis
• National Heart, Lung, and Blood Institute – Vasculitis
• NHS – Vasculitis
• Vasculitis Foundation
• National Institute of Arthritis and Musculoskeletal and Skin Diseases