Vasculitis

Giant cell arteritis (GCA) and Takayasu arteritis are the two conditions which most commonly cause large vessel vasculitis. GCA, also known as temporal arteritis, is the most common form of vasculitis in older people and can lead to serious complications including sudden-onset vision loss and damage to the large blood arteries in the chest and neck if not identified and treated promptly. Patients usually experience one or more of five cardinal symptoms – namely headache, jaw pain on chewing, vision disturbance, inflammatory shoulder and hip stiffness (polymyalgia rheumatica) and night sweats/unexplained weight loss. If your GP or specialist suspects you may have GCA you will be started on treatment immediately while a diagnosis is confirmed. A/Prof Sammel can help to decide on an appropriate diagnostic strategy which may include a PET scan, ultrasound and/or temporal artery biopsy and a management pathway to control the condition while minimising medication side effects.

Takayasu arteritis affects younger people, usually under the age of 40. It causes inflammation of the major arteries in the chest/abdomen and neck. It has historically been known as the pulseless disease as patients or their doctors may notice an absent pulse in an arm or leg due to blood vessel blockage from untreated inflammation. Patients often feel generally unwell and may have night sweats, fevers and/or weight loss due to immune system attack on their body.

Small vessel vasculitis is more common than medium and large vessel vasculitis. It can affect people of any age and has a large number of causes including medications, infections and autoimmune conditions. Depending on the cause and parts of the body affected, it can either be a minor problem and resolve on its own or be a life threatening condition requiring urgent aggressive treatment. A careful clinical assessment, along with specialised blood tests and sometimes a biopsy of the affected part of the body is needed to make a diagnosis and arrive at a management plan.

Some conditions can result in vasculitis of many vessel sizes or may only involve localised parts of the body. These are rare diseases which require a thorough assessment of all parts of the body to help determine treatment goals and the most appropriate therapy. Some conditions (organ limited vasculitis) may require no treatment while others (eg.  IgG4-related disease, Behcet disease) may respond well to targeted medications such as B cell depletion and TNF-alpha inhibitors.

A/Prof Sammel has expertise in assessing patients with unusual vascular problems to determine if vasculitis or another condition is the cause. Making a correct diagnosis means that appropriate treatment and monitoring can be instituted.