All You Need to Know About Immune Complex Vasculitis

All You Need to Know About Immune Complex Vasculitis

Immune complex vasculitis is a form of blood vessel inflammation. It is one of the subgroups of vascular inflammation.

What is immune complex vasculitis?

According to abbreviationfinder, the various gastrointestinal and neurological symptoms cause numerous complications, such as epilepsy or intestinal infarction, which can be fatal. If the heart is involved, angina pectoris can result, which can lead to a heart attack.

Immune complex vasculitis is a form of vascular inflammation (vasculitis). Vasculitis causes the walls of the blood vessels to become inflamed. Immune complex vasculitis occurs when the vascular inflammation is caused by an immunological reaction. Immune complexes are deposited on the walls of numerous smaller blood vessels.

Doctors then also speak of leukocytoplastic vasculitis, allergic vasculitis or hypersensitivity vasculitis . Doctors distinguish between cutaneous and systemic immune complex vasculitis:

In cutaneous immune complex vasculitis, sufferers suffer from inflammation of the small blood vessels near the skin. In the run-up to the vascular inflammation, a bacterial infection, which is usually caused by streptococci, or a viral disease appears.

If, on the other hand, the vasculitis is caused by antibodies and takes a chronic course, this can usually be traced back to hepatitis C. There is talk of systemic immune complex vasculitis when not only the skin is affected by the vascular inflammation, but also the kidneys and the entire central nervous system.

Causes

Immune complex vasculitis is caused by the deposit of larger immune complexes originating from the blood on the vessel walls of the blood vessels. This usually happens due to an over-sensitivity of the immune system to drugs or components of germs. Sometimes the leukocytoplastic vasculitis also appears in the context of a systemic immune complex vasculitis.

The formation of smaller immune complexes occurs, among other things, when a smaller wound is infected with bacteria. These are bound in the wound by specific antibodies of the organism. The complexes can be easily dissolved in the blood. Their degradation takes place in the liver. However, if larger accumulations of foreign substances and corresponding antibodies come together, this leads to the formation of large immune complexes.

This process usually takes place in the context of infections in which a larger number of germs penetrates the blood. The most common triggers include throat infections caused by viruses or streptococcus bacteria, and infections with hepatitis B or hepatitis C viruses. Some people also develop antibodies to drugs such as certain antibiotics, painkillers, birth control pills, or diuretics.

If large amounts of germs or drugs against which antibodies already exist get into the blood, this results in the formation of huge immune complexes. Since these are difficult to dissolve in the blood, they are deposited as solid substances on the walls of the blood vessels. This is especially true in blood vessels where there is slow blood flow, such as very small veins.

If the immune complexes are deposited on the vessel walls, this leads to a migration of leukocytes (white blood cells) from the blood into the vessel walls. This in turn triggers an inflammatory response. The leukocytes attempt to break down the immune complexes by releasing certain components, but this is only partially successful. Somewhat accidentally, the aggressive ingredients can penetrate into adjacent tissues, causing further damage to the blood vessel walls.

Symptoms, Ailments & Signs

The typical symptoms of immune complex vasculitis include many small hemorrhages that are visible on the skin. They first show up on the lower legs in the form of red dots, which can reach a maximum size of three millimeters. After a few days, the dots turn blue-red. In addition, red bleeding occurs in the lower and thigh region. However , itching or burning occurs only occasionally.

In the case of a stronger inflammatory reaction, the dark red nodules reach a diameter of several millimeters. If the immune complex vasculitis is severe, the top layer of skin in the middle of the nodules dies off, which is noticeable by a light gray discoloration or blistering.

Furthermore, superficial skin defects form that weep. In the worst case, tissue necrosis is also possible, which is noticeable in the form of soluble black nodules and small, painful wounds.

Diagnosis & course of disease

As part of the examination, the doctor asks the patient whether they had an infection some time ago or whether they are taking new medicines. He also wants to know whether the person concerned suffers from underlying chronic diseases. Finally, the patient’s skin is checked. The doctor pays particular attention to the red spots.

Two tissue samples (biopsy) are taken to confirm the diagnosis. The first sample is checked microscopically in a laboratory for vascular inflammation. In the second sample, immune complexes deposited on the walls of the vessels can be detected using the immunofluorescence method. If the immune complex vasculitis is not treated or if the central nervous system is involved, the disease usually takes a negative course.

Complications

The immune complex vasculitis causes bleeding in the skin. These hemorrhages are visible to those affected as small dots and can change color and become larger as the disease progresses. In most cases, the affected regions also experience severe itching and burning pain.

It is not uncommon for the pain to also appear in the form of pain at rest and can thus lead to considerable sleep disorders and irritability in the patient. In severe cases, the upper layers of skin in the respective regions can also die off completely, which can lead to the formation of scars and blisters. This manifests itself in reduced aesthetics and thus reduced self-esteem.

In the treatment of immune complex vasculitis, in most cases there are no special complications. First and foremost, the underlying disease that is responsible for the immune complex vasculitis is always treated. If inflammation has already occurred, antibiotics can be taken to counteract it. Life expectancy is not reduced by the disease and there are no further symptoms after treatment.

When should you go to the doctor?

Anyone who suddenly notices bleeding on the skin should see a doctor. The skin changes indicate a skin disease that needs to be clarified and treated if necessary. Whether this is an immune complex vasculitis can only be determined by a doctor. Therefore, medical advice should be sought at the first sign of illness. Clear warning signs that must be clarified as soon as possible are bluish-red discolorations on the skin, often associated with itching or burning.

At the latest when the inflammation gets bigger or the skin areas die off, a doctor’s visit is indicated. The disease often occurs after infection with hepatitis B or hepatitis C viruses. Taking painkillers or antibiotics can also lead to immune complex vasculitis. To whom these factors apply, the symptoms mentioned should be clarified quickly. In addition to the family doctor, a dermatologist or an immunologist can be consulted. Patients with chronic complaints should consult a therapist, as the disease often has an impact on the psyche.

Treatment & Therapy

The treatment of immune complex vasculitis depends on the triggering causes. If drugs or a pathogen are responsible for the hypersensitivity, it is important to switch off the trigger. As a rule, the inflammatory symptoms will soon subside again. If bacteria are involved in the vascular inflammation, the administration of antibiotics can be useful.

If the cause is a specific drug, it is discontinued or replaced with another drug. Wearing special compression stockings is considered helpful . In this way, the blood flows faster in the small vessels, which means that no new immune complexes can be deposited on the vessel walls. In most cases, cortisone therapy is also carried out.

Outlook & Forecast

Immune complex vasculitis requires comprehensive treatment. If the non-bacterial inflammation of the blood vessels is not treated, the prognosis is unfavorable. The various gastrointestinal and neurological symptoms cause numerous complications, such as epilepsy or intestinal infarction, which can be fatal. If the heart is involved, angina pectoris can result, which can lead to a heart attack.

The patients are severely restricted in their quality of life due to the condition and have to take a wide variety of medications. Nevertheless, well-being is reduced, which can also result in long-term psychological problems. Even comprehensive treatment does not guarantee recovery. If the central nervous system is involved, a fatal outcome is likely. Those affected generally have a reduced life expectancy.

Factors such as early treatment and being in good physical condition, other than immune complex vasculitis, improve the chances of recovery. With comprehensive medical therapy, the cause of the condition can be treated within a period of three months to several years. Accompanying this, symptomatic therapy is necessary. The prognosis is worse in children, the elderly and patients with an immune deficiency. Most of these patients die from the typical endothelial swelling or other complications in the first weeks to months after the onset of the immune complex vasculitis.

Prevention

Preventive measures against immune complex vasculitis are not known. This makes it all the more important to start treatment as soon as possible in the event of illness.

Aftercare

In most cases, those affected with immune complex vasculitis do not have any special options for aftercare, so that a quick diagnosis should be made in the first place for this disease. Early diagnosis and early initiation of treatment usually result in a positive course of the disease.

Self-healing cannot occur with this disease. As a rule, those affected by immune complex vasculitis have to discontinue certain medications or replace them with others. However, you should always consult a doctor. When taking medication, it is always important to ensure that the dosage is correct and that it is taken regularly in order to relieve the symptoms properly and permanently.

If you have any questions or are unclear, it is advisable to consult a doctor first. Wearing compression stockings can often have a positive effect on the course of immune complex vasculitis. Due to the illness, many patients also need the help of their own family or friends in their everyday life.

Loving conversations with those affected often have a positive effect on the course of the disease and can sometimes prevent the onset of depression or other psychological complaints. The life expectancy of those affected may be reduced as a result of the disease.

You can do that yourself

Unfortunately, immune complex vasculitis cannot be prevented directly. For this reason, a doctor should always be consulted immediately if the disease occurs. The earlier the disease is treated, the higher the chances of a positive course of the disease. Unfortunately, the possibilities for self-help are also severely limited with this disease.

If the doctor prescribes antibiotics for the patient, they should be taken. When taking antibiotics, the corresponding instructions must be observed. The use of other medications should also be checked. Furthermore, the symptoms of immune complex vasculitis can be limited by wearing compression stockings. These can usually be prescribed by a doctor. Also a therapy with cortisonehas a positive effect on the course of the disease. In a self-experiment, the person concerned should pay attention to whether certain medications increase the symptoms of the immune complex vasculitis. If this is the case, the medication can be discontinued or replaced with other medication after consultation with the doctor treating you.

Skin complaints or scars can also be limited and avoided with the help of nourishing ointments or creams. In serious cases, however, a surgical procedure is suitable to avoid aesthetic problems.

Immune Complex Vasculitis

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