Arteritis

Written by Janet Barwell and Winnie Yu | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

Overview

Arteritis refers to inflammation in the arteries that damages the blood vessel walls, and reduces the blood flow to the organs. There are several types of arteritis. The symptoms and problems that result depend on which arteries are affected, and the degree of damage that takes place.

What Causes Arteritis?

No one knows what causes arteritis. It is believed to be an autoimmune disorder. Your immune cells attack the walls of your major blood vessels, causing varying degrees of damage. The immune bodies inside the blood vessels form nodules, called granulomas that block blood flow to other parts of the body. The interior cells of the blood vessels may be weakened, making them prone to aneurysms. Aneurysms can rupture and cause internal bleeding.

The real damage comes from the loss of blood and oxygen to your internal organs. Impaired blood flow to the body organs can cause blindness, heart failure, and kidney failure, depending on which arteries are involved. Rapid treatment is necessary to prevent organ damage from arteritis.

What Are The Types of Arteritis?

You can develop several types of arteritis, each with unique symptoms and consequences depending on which arteries are involved.

Takeyasu’s Arteritis (Also Known as Aortic Arch Syndrome or Nonspecific Aortoarteritis)

Takeyasu’s arteritis affects mostly younger Asian women, particularly of Japanese descent. The disease is characterized by inflammation of the walls of the aorta and its upper branches. The condition results in the formation of lesions that eventually block and destroy the walls of the aorta.

The walls of the aorta grow thicker over time. The progressive narrowing of the upper and lower branches of the aorta leads to insufficient blood and oxygen supply to the rest of the body. Destruction of the main branches of the aorta may result in little or no upper body pulse.

Reduced blood flow can cause retinal hemorrhage, blindness, aortic regurgitation, congestive heart failure, and other problems. Destruction of the artery wall can enable the formation of aortic aneurysms, increasing the potential for ruptures in those aneurysms. Takeyasu’s arteritis often causes premature death in young women.

Giant Cell Arteritis (Also Known as Temporal Arteritis)

Giant cell arteritis (GCA) is an infection of the superficial temporal artery and other arteries supplying blood to the head, eyes, and jaw. GCA is mostly seen in women over the age of 50 of northern European heritage.

GCA generally starts out with flu-like symptoms including a severe headache, fever, aches and pains, loss of appetite, and a general feeling of malaise. The affected arteries can be painful, red and warm to the touch. As the nerves become increasingly inflamed, blood flow can be disrupted to facial nerves, optic nerves or the jaw, resulting in vision loss, jaw pain, scalp pain, and other symptoms.

The greatest risk with GCA is vision loss when the ocular arteries are blocked. GCA is rarely fatal, but immediate treatment is necessary to prevent permanent blindness.

Polyarteritis Nodosa (Also Known as Kussmaul Disease, Kussmaul-Maier Disease or Infantile Polyarteritis Nodosa)

Polyarteritis nodosa (PN) is an inflammation of the medium and smaller arteries that carry blood from the heart to your organs and tissues. Symptoms vary, depending on which blood vessels are involved. In most cases, the cause is unknown. Polyarteritis nodosa occurs mostly in men between the ages of 30-49, and occasionally in people with hepatitis B.

Because so many blood vessels can be involved, the symptoms and effects of PN are quite varied. Like other forms of arteritis, polyarteritis nodosa often begins with a cluster of flu-like symptoms such as headache, fever, muscle and joint aches, fatigue, weakness, and loss of appetite. Your skin may also break out in rashes and sores.

When the central nervous system is involved, you may experience pain, burning, numbness or weakness in your hands or feet. When your kidneys are involved, you may develop irenal failure, high blood pressure, and edema. Heart attacks, heart failure, or pericarditis can occur when the arteries to your heart are inflamed.

Polyarteritis nodosa can be quickly brought under control with immune suppression drugs. However, you will be at high risk for relapse in the future.

How Is Arteritis Diagnosed?

Arteritis is diagnosed with a patient exam and history, lab tests, imaging, and biopsies of the affected blood vessels.

Patient History

Your doctor will take a detailed patient history that may include:

  • your race, age, and gender
  • the pattern of your early symptoms
  • later symptoms
  • visual examination of the parts of your body that are affected

Lab Tests

Your doctor may also order lab tests such as:

  • erythrocyte sedimentation rate (ESR) to detect inflammation
  • C-reactive protein (CRP) to detect inflammation
  • complete blood count (CBC) to detect signs of infection and anemia
  • liver function test (LFT) to detect alkaline phosphatase, commonly found in arteritis

Imaging

Your doctor may order ultrasounds, angiograms, CT scans, and MRIs to assess the condition of your arteries, the degree of blockage, and whether aneurysms are present.

Biopsy

A biopsy of your blood vessels may be required to examine the condition of the cell walls.

How Is Arteritis Treated?

Treatment of arteritis focuses first on suppressing the immune reaction with corticosteroids such as prednisone, or other immune suppression drugs. Secondary infections are then brought under control using antibiotics. Finally, if any of your organs have been damaged, you may need surgery to restore them to a healthier state.

What Is The Long-Term Outlook?

Most people make a recovery from arteritis. But it is possible that treatment may take a year or two. A recurrence is also possible.

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