Vasculitis: Symptoms, Causes, Treatment & Complete Guide
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Vasculitis is inflammation of the blood vessels that can thicken and narrow vessel walls, restricting blood flow and damaging organs and tissues. It often causes vague symptoms such as fever, headache, tiredness and weight loss, plus organ-specific signs. In many types, the immune system attacks blood vessels by mistake. Treatment centers on corticosteroids, and long-term follow-up is needed.
What the research says
Tocilizumab helped more people with giant cell arteritis reach steroid-free remission. In a 1-year randomized trial of 251 patients, sustained glucocorticoid-free remission at week 52 occurred in 56% of those given weekly tocilizumab and 53% of those given it every other week (each with a 26-week prednisone taper), compared with 14% of the placebo group on a 26-week taper and 18% on a 52-week taper (P<0.001 for each comparison with placebo). Median cumulative prednisone dose was 1,862 mg with tocilizumab versus 3,296 mg and 3,818 mg with placebo, and serious adverse events occurred in 14% to 15% of tocilizumab groups versus 22% to 25% of placebo groups. (Stone et al., N Engl J Med, 2017) [3]
Rituximab worked as well as cyclophosphamide for severe ANCA-associated vasculitis, and may work better when the disease relapses. In a randomized, double-blind noninferiority trial of 197 patients with granulomatosis with polyangiitis or microscopic polyangiitis, 64% of the rituximab group reached remission without prednisone at 6 months versus 53% of the cyclophosphamide group (noninferiority P<0.001). Among patients with relapsing disease, 67% (34 of 51) reached remission with rituximab versus 42% (21 of 50) with cyclophosphamide (P=0.01), and adverse event rates did not differ significantly between groups. (Stone et al., N Engl J Med, 2010) [4]
Vasculitis at a Glance
Aspect | Summary |
Definition | Swelling and irritation (inflammation) of blood vessels |
The mechanism | Inflamed walls thicken → vessels narrow → blood flow restricted → organs and tissues damaged |
Scope | May affect one organ or several; short-term or long-lasting |
How common | Many types exist; most are rare |
General symptoms | Fever, headache, tiredness, weight loss, aches and pains |
Core cause | Often immune system attacking blood vessel cells by mistake |
Nine named types | Behcet, Buerger, cryoglobulinemia, EGPA, giant cell arteritis, granulomatosis with polyangiitis, Henoch-Schonlein purpura, Kawasaki, Takayasu's arteritis |
Diagnosis | Blood tests, imaging, angiography, biopsy |
Main treatment | Corticosteroids (prednisone) + steroid-sparing medicines; surgery for aneurysms/blocked arteries |
The catch | Most types can flare and return — long-term follow-up needed |
What Is Vasculitis?
Vasculitis involves swelling and irritation of blood vessels — the inflammation that gives the condition its name. The sequence of damage is straightforward but consequential: the inflammation causes the walls of the blood vessels to thicken, this thickening narrows the vessels, and if the narrowing restricts blood flow, it can damage organs and tissues.
The condition is a broad family rather than a single disease. There are many types of vasculitis, and most of them are rare. Vasculitis might affect just one organ or several, and it can be short-term or long-lasting. It can affect anyone — but some types are more common among people in certain age groups.
An important note on prognosis: some types may improve without treatment, while most types need treatment with medicines to control the inflammation and prevent flares.
The Nine Named Types
The nine major named types of vasculitis include:
Type | Notes |
Behcet disease | Can run in families |
Buerger disease | Linked to tobacco smoking, mainly in people assigned male at birth under 45 |
Cryoglobulinemia | Associated with hepatitis C infection |
EGPA (formerly Churg-Strauss syndrome) | Detailed in our Churg-Strauss syndrome guide |
Giant cell arteritis | Rare before age 50; more common in people assigned female at birth; can cause blindness if untreated |
Granulomatosis with polyangiitis | Can run in families |
Henoch-Schonlein purpura | — |
Kawasaki disease | Most common in children younger than 5; can run in families |
Takayasu's arteritis | — |
Symptoms: Five Vague Signals Plus Organ-Specific Signs
Symptoms of most types of vasculitis can include five general warning signals: fever, headache, tiredness, weight loss, and aches and pains. These are vague enough to mimic many other illnesses — which is exactly why the organ-specific signs matter.
Other symptoms depend on the parts of the body affected:
Body Area | What Vasculitis Can Cause |
Skin | Bleeding under the skin showing up as red spots; lumps or open sores |
Digestive system | Pain after eating; ulcers and tears (perforations); blood in the stool |
Lungs | Shortness of breath; coughing up blood |
Eyes | Red, itchy or burning eyes; giant cell arteritis can cause double vision and brief or ongoing blindness in one or both eyes — sometimes the first sign of the disease |
Ears | Dizziness, ringing in the ears, sudden hearing loss |
Hands or feet | Numbness or weakness in a hand or foot; palms and soles might swell or harden |
When to See a Doctor
Make an appointment with your healthcare professional if you have symptoms that worry you. Get emergency care for sudden vision changes, a new severe headache with jaw pain or scalp tenderness, or coughing up blood. Some types of vasculitis get worse quickly — and early diagnosis is the key to getting treatment that works.
Causes: The Immune System Misfire
Experts don't know the exact cause of vasculitis. Some types are linked to a person's genes. Others result from the immune system attacking blood vessel cells by mistake. Causes of this immune system reaction may include:
Immune Trigger | Examples |
Infections | Hepatitis B and hepatitis C |
Blood cancers | — |
Immune system diseases | Rheumatoid arthritis, lupus, scleroderma |
Reactions to certain medicines | — |
Risk Factors
Vasculitis can happen to anyone, but these factors may increase the risk of certain types:
Risk Factor | Details |
Age | Giant cell arteritis is rare before age 50; Kawasaki disease is most common in children younger than 5 |
Family history | Behcet disease, granulomatosis with polyangiitis, and Kawasaki disease can run in families |
Lifestyle choices | Illicit drugs such as cocaine increase risk; tobacco smoking increases the risk of Buerger disease, mainly in people assigned male at birth younger than 45 |
Medicines | Hydralazine, allopurinol, minocycline, and propylthiouracil sometimes can cause vasculitis |
Infections | Hepatitis B or C increases the risk |
Immune conditions | Lupus, rheumatoid arthritis, and scleroderma carry higher risk |
Sex assigned at birth | Giant cell arteritis is much more common in people assigned female at birth; Buerger disease is more common in people assigned male at birth |
Complications
Complications depend on the type of vasculitis and how severe it is — and may also be linked to side effects of the prescription medicines that treat the condition:
Complication | What Happens |
Organ damage | Some types of vasculitis can damage major organs |
Blood clots and aneurysms | A blood clot may form, blocking blood flow; rarely, the vessel weakens and bulges into an aneurysm — for a deeper look, see our guides on aortic aneurysm and abdominal aortic aneurysm |
Vision loss or blindness | A possible complication of giant cell arteritis that isn't treated |
Infections | Some treatment medicines weaken your immune system, making you more prone to infections |
How Is Vasculitis Diagnosed?
Diagnosis starts with a medical history and a physical exam. You may then have one or more tests and procedures — either to diagnose vasculitis or to rule out other conditions that cause some of the same symptoms:
Test | What It Reveals |
Blood tests | Signs of inflammation, such as a high level of C-reactive protein; a complete blood cell count showing whether you have enough red blood cells; the ANCA test (antineutrophil cytoplasmic antibody), which looks for certain antibodies |
Imaging tests | Which blood vessels and organs are affected, and how well you respond to treatment — X-rays, ultrasounds, CT scans, MRIs, and PET scans |
Angiography (X-rays of blood vessels) | A flexible catheter resembling a thin straw goes into a large artery or vein; a special dye flows into the catheter; X-rays taken as the dye fills the vessel show the outlines of your blood vessels |
Biopsy | A surgery in which a small tissue sample is removed from the affected area and examined for signs of vasculitis |
Treatment: Control the Inflammation, Prevent the Flare
Treatment aims to control the inflammation and to manage the conditions that may be causing the vasculitis. One expectation matters: most types of vasculitis can come back — this is called a flare — so your healthcare professional may need to follow you for a long time after your symptoms go away.
Medications
A corticosteroid medicine, such as prednisone, is the most common type of medicine prescribed to control the inflammation of vasculitis. Corticosteroids can have bad side effects, and the longer you take them, the worse the side effects may be — including weight gain, diabetes, and weakened bones. If you need a corticosteroid long-term, you get the lowest dose that will help.
Your healthcare professional may add other medicines to corticosteroids to control the inflammation, so you can lower the corticosteroid dose more quickly. The medicine used depends on the type of vasculitis:
Steroid-Sparing Medicine | Role |
Methotrexate | Helps control inflammation alongside corticosteroids |
Azathioprine | Helps control inflammation alongside corticosteroids |
Mycophenolate mofetil | Helps control inflammation alongside corticosteroids |
Cyclophosphamide | Helps control inflammation alongside corticosteroids |
Tocilizumab | Helps control inflammation alongside corticosteroids |
Rituximab | Helps control inflammation alongside corticosteroids |
Which medicines you need depend on the type of vasculitis you have, how bad it is, which organs are involved, and any other medical problems you have.
Surgery
Sometimes vasculitis causes a balloonlike bulge in the wall of a blood vessel — an aneurysm. This bulge may need treatment with surgery to lower the risk of it breaking. Blocked arteries also may need surgical treatment to restore blood flow to the affected area.
Coping and Support
Coping with the side effects of the medicines you take to treat your vasculitis might be one of the hardest things about living with the condition. These six practices can help:
Know about your condition. Learn all you can about vasculitis and its treatment, including the possible side effects of your medicines — and tell your healthcare professional about any changes in your health.
Follow your treatment plan. Your plan may include seeing your health professional often, having more tests, and checking your blood pressure.
Eat well. Healthy foods can help prevent medicine-related problems such as thinning bones, high blood pressure, and diabetes. Eat mainly fresh fruits and vegetables, whole grains, low-fat dairy products, and lean meats and fish. If you're taking a corticosteroid, ask whether you need a vitamin D or calcium supplement.
Get vaccinations. Some vasculitis medicines raise your risk of infections. Staying up to date on flu, pneumonia, shingles, and COVID-19 vaccinations can help — talk with your healthcare professional about which ones to get.
Exercise most days of the week. Regular aerobic exercise, such as walking, can help prevent corticosteroid-linked bone loss, high blood pressure, and diabetes — and it helps your heart, lungs, and mood. If you're not used to exercising, build up slowly; your healthcare professional can help plan a program.
Ask others to help. Family and friends can help you cope, and talking with others who have vasculitis may help. Ask your healthcare team about support groups.
Preparing for Your Appointment
Make an appointment with your main healthcare professional if you have symptoms that worry you. For vasculitis, you may need to see specialists — and the right specialist depends on which organs are affected:
Specialist | Focus |
Rheumatologist | Joints, muscles, and autoimmune diseases |
Neurologist | Brain and nervous system |
Ophthalmologist | Eyes |
Cardiologist | Heart |
Nephrologist | Kidneys |
Pulmonologist | Lungs |
Dermatologist | Skin |
Urologist | Urinary tract and urogenital systems |
Otorhinolaryngologist | Ears and sinuses |
What You Can Do
Ask about preparation — when you make the appointment, ask if you need to do anything in advance, such as restricting your diet.
Send test information — if you're seeing a specialist, ask your main healthcare professional to send your imaging and biopsy results before the appointment.
List all your symptoms, and when they began.
List key personal medical information, including other recent health issues or major stresses, and all medicines, vitamins and supplements with doses.
Ask a family member or friend to go with you — they can help you remember the information you get.
List questions you want to ask your healthcare team.
Questions to Ask
What type of vasculitis do I have?
What's causing my vasculitis?
Will my vasculitis go away on its own or is there a cure?
Should I see a specialist?
What are my treatment choices?
I have another medical condition — how can I best manage these conditions together?
Do you have brochures or other printed material? What websites do you suggest?
What Your Doctor Will Ask
Do your symptoms stay with you or do they come and go?
How bad are your symptoms?
What, if anything, seems to make your symptoms better?
What, if anything, seems to make your symptoms worse?
Frequently Asked Questions
What is vasculitis?
Vasculitis is inflammation — swelling and irritation — of blood vessels. The inflammation can thicken vessel walls, narrow the vessels, and, if blood flow becomes restricted, damage organs and tissues.
What are the symptoms of vasculitis?
Most types cause fever, headache, tiredness, weight loss, and aches and pains. Other symptoms depend on the organs affected: red skin spots and sores, pain after eating or blood in the stool, dizziness or hearing loss, red or burning eyes, numbness or weakness in hands and feet, and shortness of breath or coughing up blood.
What causes vasculitis?
The exact cause is unknown. Some types are linked to genes. In others, the immune system attacks blood vessel cells by mistake — a reaction that may be triggered by infections such as hepatitis B and C, blood cancers, immune diseases such as rheumatoid arthritis and lupus, or reactions to certain medicines.
What are the main types of vasculitis?
There are many types, most of them rare. The major named types include Behcet disease, Buerger disease, cryoglobulinemia, EGPA (formerly Churg-Strauss syndrome), giant cell arteritis, granulomatosis with polyangiitis, Henoch-Schonlein purpura, Kawasaki disease, and Takayasu's arteritis.
How is vasculitis diagnosed?
Diagnosis starts with a medical history and physical exam, then may include blood tests (C-reactive protein, blood count, ANCA antibody test), imaging tests (X-ray, ultrasound, CT, MRI, PET), angiography with dye, and a biopsy of the affected tissue.
How is vasculitis treated?
Treatment aims to control inflammation, most often with a corticosteroid such as prednisone, frequently combined with other medicines (methotrexate, azathioprine, rituximab, and others) so the steroid dose can be lowered. Surgery treats aneurysms and blocked arteries, and long-term follow-up is important because flares are common.
Can vasculitis come back after treatment?
Yes — most types of vasculitis can come back in a flare, so healthcare professionals typically continue following patients for a long time after symptoms go away.
Is vasculitis contagious?
No. Vasculitis is not spread from person to person, though some infections can trigger certain types.
What are the side effects of vasculitis treatment?
Steroids and other immune-lowering medicines can raise the risk of infection and cause side effects such as weight gain, mood changes and bone loss. Your provider will monitor you and adjust treatment.
When is vasculitis an emergency?
Call 911 for sudden vision loss, chest pain, trouble breathing, coughing up blood, signs of stroke, or severe belly pain. These can mean an organ is not getting enough blood.
Conclusion
The three lessons to carry away from this guide:
Vague symptoms deserve attention: fever, headache, tiredness, weight loss, and aches and pains — especially alongside red skin spots, vision changes, or lung symptoms — are the calling cards of vasculitis, and since some types worsen quickly, early diagnosis is the key to treatment that works.
It's an immune misfire, not a contagion: the immune system attacks blood vessel cells by mistake, triggered by infections, immune diseases, certain medicines, or genetics — and knowing your risk factors (age, smoking, family history) helps your care team move faster.
Treatment is a long game: corticosteroids control the inflammation, steroid-sparing medicines reduce the dose, surgery fixes aneurysms and blockages, and because flares are common, staying engaged with your team — eating well, exercising, and staying vaccinated — is part of the medicine itself.
This guide has walked you through what vasculitis is, the nine named types, the organ-specific symptom map, the immune-system causes, the four-part diagnostic toolkit, the treatment ladder, and the daily practices that protect you from medicine side effects. If one of the specific types sounds familiar, our guide to Churg-Strauss syndrome (EGPA) goes deep on that form.
Your Next Steps
Read a related guide — Explore our Churg-Strauss syndrome (EGPA) guide for a deep dive on one form of vasculitis.
Share your thoughts — Have you been diagnosed with vasculitis or supported someone who has? Leave a comment below — your experience may help another reader.
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Related Reading
C-Reactive Protein (CRP) Test: Normal Levels, High CRP and What Results Mean explains what this inflammation blood test measures and what high levels mean.
Cerebral Angiogram: What It Shows, How to Prepare, What to Expect, Risks and Recovery explains how a catheter and contrast dye show the brain's blood vessels, how to prepare and the risks.
ANCA Test: c-ANCA vs p-ANCA, What It Checks and What Results Mean explains the blood test for antibodies linked to small-vessel vasculitis.
References
Mayo Clinic Staff. Vasculitis - Symptoms and causes. Mayo Clinic. February 5, 2025. https://www.mayoclinic.org/diseases-conditions/vasculitis/symptoms-causes/syc-20363435
Mayo Clinic Staff. Vasculitis - Diagnosis and treatment. Mayo Clinic. February 5, 2025. https://www.mayoclinic.org/diseases-conditions/vasculitis/diagnosis-treatment/drc-20363485
Stone JH, et al. Trial of Tocilizumab in Giant-Cell Arteritis. N Engl J Med. 2017;377(4):317-328. PMID 28745999. https://doi.org/10.1056/NEJMoa1613849
Stone JH, et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med. 2010;363(3):221-232. PMID 20647199. https://doi.org/10.1056/NEJMoa0909905
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