Vasculitis and Autoimmunity
Earlier this month, actor Ashton Kutcher revealed he has been battling a rare form of an autoimmune disease called vasculitis that, “knocked out his vision, hearing, and equilibrium” – the actor adding that it took a year to start feeling back to normal. The stunning news has many people wondering what exactly vasculitis is. Before understanding vasculitis, it is important to understand autoimmune diseases and their complexity.
“Autoimmunity means that our body is trying to destroy our own organs. Whether it be joints or lungs or vessels – whatever the organ is determines the type of autoimmune disease. It is a chronic condition and is not something that goes away within a few days. Once diagnosed, people should follow up closely with a rheumatologist and most likely be placed on long-term medications,” says Dr. Soumyasri Kambhatla, an OSF HealthCare rheumatologist.
When someone is diagnosed with an autoimmune disease, it means that that their immune system has started to attack healthy cells in the body, rather than protecting it. It is not exactly clear why this happens, and they can be difficult to diagnose. There are more than 100 known autoimmune diseases that affect all parts of the body – from joints, muscles, and organs to the endocrine and nervous systems. Vasculitis is one of these 100-plus autoimmune diseases.
“What it actually means is inflammation of the vessel walls. There are a lot of blood vessels running through our body that are classified as large, medium, or small size. Vasculitis means the vessel walls themselves get inflamed, resulting in closure of these vessels, leading to ischemia, which means loss of blood to the tissues and organs – leading to damage to those particular organs,” Dr. Kambhatla explains.
According to the American College of Rheumatology, there are many types of vasculitis and they may vary greatly in symptoms, severity and duration. Cases of vasculitis can range from mild to life-threatening.
Dr. Kambhatla says knowing which vessels are being affected is important in order to determine the type of vasculitis and the best course of treatment.
“When we are talking about large vessel vasculitis, it means the inflammation is in the large vessels. These are the vessels coming from the heart that go into the brain. This can present as strokes, headaches, loss of vision, pain when chewing, fatigue or tiredness in the jaw when chewing, sore throat, or ulcers in the mouth – things like that,” says Dr. Kambhatla.
She continues: “When talking about medium and small vessel vasculitis, the presentation can be a little different. The vessels affected are in the organs like skin, kidneys, and lungs. If it is affecting the kidneys, there can be dark brown urine. If it is in the stomach, there might be pain in the belly or blood in the stool. If it’s affecting the lungs, there can be blood in the sputum, difficulty breathing, and chest pain – and so on.”
While Kutcher has not shared the type of vasculitis he was diagnosed with, his symptoms include trouble with vision, hearing, and balance, which could all be signs of a type of large vessel vasculitis.
According to the American College of Rheumatology, treatment options for all forms of vasculitis typically can include steroids, immune-suppressing drugs, and, in some cases, surgery. Like with many autoimmune diseases, people with vasculitis may need to be on a medication that becomes a routine part of their day – with regular check-ups and blood tests to keep the disease under control. Dr. Kambhatla says early detection is key for the best outcome.
“The bottom line is, I would say that although vasculitis can be a deadly disease, it’s treatable if it is identified in the early stages and is detected before substantial organ damage. There is a very good chance of recovery, and every patient with vasculitis has a chance of being a success story if treated properly,” Dr. Kambhatla says.
While some modifiable risk factors like smoking can increase one’s risk for developing an autoimmune disease, it is widely believed that these diseases are mostly genetic. Because there are so many autoimmune diseases, symptoms can range all across the board, making them difficult to diagnose.
Dr. Kambhatla recommends listening to your body if you feel something is off and talking to your primary care provider about any concerns you may have. He or she can run the appropriate blood tests and can refer you to a rheumatologist if needed for further assessment.
If you are experiencing severe symptoms such as severe headaches, loss of vision, and trouble speaking, Dr. Kambhatla recommends going to the nearest emergency room to be evaluated.
Interview Clips:
Actor Ashton Kutcher recently revealed he had been diagnosed with vasculitis. Before understanding vasculitis, it is important to understand autoimmune diseases and their complexity.