Causes and symptoms of leukocytoclastic vasculitis
Vasculitis is an inflammatory process in the area of the blood vessels . The health complication is named after it because of its origin. Finally, the Latin word “vas” means vessel in German. The disease usually originates in the vessel walls, with leukocytoclastic vasculitis being the most common form of the disease. It primarily affects the hair vessels of the skin, known as capillaries. A special type of white blood cell , the granulocyte , escapes from the blood.
They penetrate the vascular walls and ensure their destruction. As a result, leukocyte vasculitis develops , which is accompanied by characteristic symptoms. These include, for example, spot bleeding and red nodules on the skin.
How does leukocyte vasculitis develop?
Leukocytoclastic vasculitis results from a hypersensitivity reaction, which doctors also call hypersensitivity reaction.
The body’s immune system reacts to parts of pathogens or certain medications. As a result, the defense system forms the protein molecules that represent the antibodies. They form a bond with the foreign substances so that immune complexes are formed. If these stick to the vessel wall, the health complication arises. This is the result of the study: “Leukocytoclastic Vasculitis” from 2004. The publication comes from C. Sunderkötter et al.
The synonyms for the phenomenon are hypersensitivity vasculitis or allergic vasculitis. There is also a form of leukocyte vasculitis in which several partial causes cause the bleeding. For example, those affected suffer from an internal disease, systemic vasculitis. This is an inflammation of the blood vessels that affects multiple organ systems. If it expands, hypersensitivity vasculitis develops.
Various forms of leukocyte vasculitis
In addition to the two variants of the disease mentioned, the following existed at the same time:
- allergic vasculitis in the context of collagen diseases,
- cryoglobulinemic vasculitis,
- Hypersensitivity vasculitis associated with Behçet’s disease,
- Illness associated with Churg-Strauss syndrome or microscopic polyangiitis.
If the doctor detects the inflammatory reaction in the area of the vessels, the first thing to do is take an anamnesis. In this he asks the patients about their health history. The results decide on the subsequent therapy.
If you suffer from cryoglobulinemic vasculitis, cryoglobulins are deposited in addition to the immune complexes. This combination of pathogens and antibodies remains insoluble primarily at low temperatures. In particular, the structures develop in patients suffering from chronic hepatitis C or a disease of the hematopoietic system. The latter is called plasmacytoma in medicine. Autoimmune diseases are also a partial cause of the development of leukocyte vasculitis. The relevant health complications include:
- rheumatoid arthritis,
- das Sjögren’s Syndrome
- and systemic lupus erythematosus.
Allergic vasculitis develops primarily when there is a relapsing deterioration in the state of health. The reason is that the autoantibodies that attack the body’s own tissues get into the immune complexes. This enlarges them, which leads to faster destruction of the vessel walls.
In Behçet’s disease, the hereditary predisposition causes the excessive release of neutrophilic granulocytes . Due to the abnormal activation, a strong inflammatory process follows, which primarily affects the organs. Since the skin is the largest human organ, hypersensitivity vasculitis occurs here. Less frequently, the occurrence of hemorrhages indicates systemic vasculitis.
Symptoms of leukocytoclastic vasculitis
Allergic vasculitis has typical characteristics. This includes numerous punctiform hemorrhages that occur on the skin of the lower legs. You will also notice, for example, dark red nodules that are remotely reminiscent of pimples.
The hemorrhages first appear on the legs, but as the disease progresses they also appear on other parts of the body. Their diameter is on average between one and three millimeters. Within the next few days, the color of the skin affected will change. They change from an intense red to a bluish-red tone.
In addition, new hematomas develop on the thighs. The skin changes are usually painless. However, it happens that you feel an unpleasant itching or a slight burning sensation. In the case of pronounced bleeding, you will see dark red nodules after several days, which indicate a stronger inflammatory reaction. They have a diameter of several millimeters. If you suffer from a severe form of leukocyte vasculitis, the epidermis dies off in the center of the nodules.
You can recognize the process by a clear discoloration of the epidermis. First it appears light gray, then it forms small bubbles. These ensure the detachment from the dermis. As a result, those affected recognize a weeping spot, which the experts call erosion. In the worst case, the connective tissue dermis also dies, causing necrosis.
When this happens, black nodules form, which fall off after several days, leaving painful sores. They are also called ulcers. In the majority of patients, allergic vasculitis develops without warning. The bleeding heals several weeks after the vascular inflammation, leaving brownish spots. Once these fade, the circumstance indicates the healing process. If the health complication is based on an internal disease, the signs reappear in phases.
In some cases, allergic vasculitis may also affect the joints. If the nodules show up in their area, you are suffering from joint pain. There is also swelling that occurs in the surrounding soft tissues. Hemorrhages often form in the ankles as well as the knee and elbow joints. If you notice that unpleasant abdominal pain repeatedly affects your everyday life, this may also result from leukocyte vasculitis. The immune complexes irritate the vessel walls within the gastrointestinal tract. Slight intestinal bleeding, for example, can give an indication.
More information for patients
Rarely, allergic vasculitis occurs in the kidneys. In this case, you usually do not notice any symptoms. If the vessels inside the kidney corpuscles, which are also called glomeruli, become inflamed, doctors speak of glomerulonephritis.
The disease ensures that proteins and red blood cells get into the urine and cause discoloration there. In the majority of those affected, the disease heals without consequences. If this does not happen, there is a risk of chronic kidney dysfunction. The experts use the term “renal insufficiency” as a technical term.
The likelihood of kidney involvement increases if the bleeding also occurs above the waistline. It also happens that the vascular inflammation affects the internal organs. This special form of allergic vasculitis is called purpura Schoenlein-Henoch.
