Mt Elizabeth (Orchard) #05-03

Shedding Light on Vasculitis: Understanding the ‘Invisible’ Battle Within 

Decoding Vasculitis: What is Vasculitis?

vasculitis
Vasculitis is characterised by the inflammation of the blood vessels and may result in purpura/vasculitic rash.  

Did you know that some types of illnesses are 'invisible' because their symptoms may not be readily apparent to others? Systemic vasculitis is one such example. Vasculitis refers to a group of diseases defined by the inflammation of blood vessels (arteries and veins). The autoimmune condition vasculitis can range from mild to severe, or even life-threatening.  There may be some physical manifestations, such as purpura (i.e. the presence of small bleeding points and red or purple discolourations on the skin). However, on the whole, vasculitis is considered an 'invisible' condition because there are fewer highly obvious physical symptoms relative to some other illnesses. 

Symptom Identification: What to Look Out For?

Depending on the type of vasculitis, age group, and gender, some of the possible symptoms include: 

  • Fatigue and weakness
  • Fever
  • Poor appetite and unintentional weight loss
  • Skin problems (rash, ulcers & purpura)
  • Long-lasting headaches and poor vision
  • Pain in the jaw
  • Nerve issues (numbness, weakness & pain)
  • Nose bleeds and difficulty with smells
  • Cough, blood in phlegm and difficulty breathing
  • Frothy urine
  • Abdominal pain      
  • Joint pain, and muscle aches
  • Chest pain     
  • Fingertips turning blue in the cold

If patients exhibit one or more of these symptoms, they should visit a rheumatologist to get an early diagnosis and start treatment. If left untreated, vasculitis can lead to severe complications as it causes inflammation of blood vessels and significantly reduces blood flow to critical organs, possibly resulting in lung and kidney inflammation, aneurysms (abnormal swelling or bulge in the blood vessel wall), and blindness.

Unfortunately, some of these symptoms and complications are not immediately visible to others, contributing to the 'invisible' nature of the disease. Individuals with vasculitis often experience muscle and joint pain, which can be uncomfortable and affect mobility. As a result, some young adults with vasculitis can look healthy but suffer from chronic pain. For instance, many need a seat on the train during their flares. This is why the the Caring SG Commuters Committee rolled out an initiative to offer specially-designed cards and lanyards to commuters with long-term, invisible medical conditions. Such societal support can greatly aid patients fighting against vasculitis.

Diagnosis: How is Vasculitis Diagnosed? 

Rheumatologists will usually advise patients who suspect that they have vasculitis to undergo one or more diagnostic tests to better understand their condition and rule out other conditions that resemble vasculitis. These tests may include:

  • Medical history taking
  • Physical examination
  • Blood tests
  • Imaging      
  • Biopsy of skin, kidney, lung or other locations affected by vasculitis 

Treatment: What Treatment Options are Available?

Currently, there is no cure for vasculitis, but proper treatment can alleviate symptoms and prevent disease progression. In general, rheumatologists prescribe immunosuppressant drugs to control inflammation and prevent complications of the condition and would advise patients to attend regular follow-up appointments.

It is important to note that there is no one-size-fits-all treatment approach for vasculitis, as treatments should be personalised based on the individual's diagnosis. Patients should consult with a rheumatologist to effectively manage their illness. 

If you are seeking a reliable and experienced rheumatologist contact Asia Arthritis & Rheumatology Centre for an appointment (link to contact us page). Alongside a committed and dedicated team, our Senior Consultant Rheumatologist, Dr Annie Law, can help you effectively manage your vasculitis and cope better in your ‘invisible’ battle against the autoimmune disorder.

References

  1. Almaani, S., Fussner, L. A., Brodsky, S., Meara, A. S., & Jayne, D. (2021, April 1). Anca-associated vasculitis: An update. Journal of Clinical Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037363/
  2. Merkel, P. A. (n.d.). Patient education: Vasculitis (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/vasculitis-beyond-the-basics?csi=bc002efc-8f3a-41ce-8161-8da850926149&source=contentShare#H20
  3. Watts, R. A., Hatemi, G., Burns, J. C., & Mohammad, A. J. (2021, December 1). Global Epidemiology of Vasculitis. Nature News. https://www.nature.com/articles/s41584-021-00718-8
  4. Abdullah, A. (2021, Mar 5). Commuters with long-term medical conditions can claim card, lanyard to help get a seat on public transport. Channel NewsAsia. https://www.channelnewsasia.com/singapore/commuters-medical-conditions-card-lanyard-seat-bus-mrt-308426

Mt. Elizabeth (Orchard)

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