Vasculitis

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Experts in Duke’s high-performing rheumatology program diagnose and treat all forms of vasculitis -- an autoimmune disorder characterized by inflammation of your blood vessels, including arteries, veins, and capillaries. We offer a team approach to care for vasculitis, also known as angiitis or arteritis. We help you manage the painful symptoms and work with specialists throughout Duke to treat the complications that can occur.

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About Vasculitis

Our rheumatologists are experts at diagnosing and treating various forms of vasculitis, including:

Giant cell arteritis
Antineutrophilic cytoplasmic antibody-associated vasculitis including granulomatosis with polyangiitis (formerly called Wegener’s granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis
Takayasu’s arteritis
Polyarteritis nodosa
IgA vasculitis (formerly called Henoch-Schonlein purpura)
Immune-complex mediated small vessel vasculitis (cryoglobulinemic vasculitis, urticarial vasculitis)
Primary angiitis of the central nervous system

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

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Treatments

We offer the latest techniques and therapies to care for vasculitis. We help you manage the disease and minimize your risk for future complications like blood clots, infections, and organ damage. Your treatment plan will depend on the severity of your symptoms. Treatment options include:

Corticosteroids

These medications (e.g. prednisone or methylprednisolone) reduce swelling, pain, and inflammation and are used to treat most types of vasculitis.

Cytotoxic Medications

Your doctor may recommend cytotoxic medications (e.g. cyclophosphamide), which kill the cells causing the inflammation.

Monoclonal Antibodies

This therapy targets specific areas of the immune system to reduce the inflammatory effects of certain types of vasculitis.

Disease Modifying Anti-rheumatic Drugs

These medications (e.g. azathioprine and methotrexate) suppress specific cells in the immune system to decrease inflammation and control disease activity related to vasculitis.

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Tests

We strive to diagnose vasculitis as early as possible to give you the best possible outcome. Your evaluation begins with a review of your medical history and a comprehensive physical exam. Other tests may include:

Blood and Urine Tests

These tests are important for diagnosis by helping to identify abnormalities in different tissues and organs, levels of inflammation, and specific antibodies. Testing may indicate that your immune system is mistakenly attacking your body’s healthy tissues.

Biopsy

While under general or local anesthesia, a small piece of tissue is removed from the affected organ -- such as the skin, kidneys, nerves, or lungs -- and examined under a microscope to help determine the extent of inflammation and whether you have vasculitis. Biopsies are usually performed as outpatient procedures, which means you will be able to go home the same day.

Imaging Tests

X-ray, ultrasound, CT, and MRI scans may be used to evaluate the different tissues and organs that may be affected by vasculitis. These tests take anywhere from 15 minutes to an hour and are virtually painless.

Angiography

This radiology test shows blood flowing through your vessels. A thin, flexible tube called a catheter is inserted into a large artery or vein and threaded to a specific area for evaluation. A special contrast dye is injected into the catheter to make the arteries and veins visible on X-rays. The images from an angiogram may reveal abnormal narrowing or blockages of blood vessels, which would support a diagnosis of vasculitis. The procedure takes two to three hours, and you will receive moderate sedation (which means you will be awake for the procedure, but you will be relaxed and unable to feel pain).

High-Performing Hospital for Rheumatology in the U.S.

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our rheumatology program is rated as high-performing among the nation's top hospitals, according to US News & World Report for 2024–2025.

Why Choose Duke

A Collaborative Approach
Vasculitis can affect tissues and organs throughout the body, including the lungs, kidneys, nerves, and skin. Our doctors work closely with specialists in dermatology (skin), neurology or neuroimmunology (nervous system), nephrology (kidney), radiology (imaging), ophthalmology (eye), urology (urinary system), cardiology (heart) and otolaryngology (ears, nose, throat). Our team approach ensures you receive the most thorough care.

Active Research Program
Our rheumatologists are also researchers who seek to gain a better understanding of vasculitis, what causes it, and the most effective treatment options. As a result, you may benefit from the latest treatment guidelines and have access to new therapies before they become widely available.

This page was medically reviewed on 09/02/2024 by

Catherine A. Sims, MD | Rheumatologist