Living with vasculitis means managing symptoms daily, but even with the best care, flare-ups can still occur. Depending on the type and severity of vasculitis, flare-ups can range from mild discomfort to severe health complications.
Why do vasculitis symptoms sometimes lie low for weeks, only to suddenly come roaring back? The answer lies in the complex relationship between your immune system, environment, and daily habits. And understanding the causes behind vasculitis flare-ups is crucial for effective management.
What Is Vasculitis? What Constitutes a Flare-Up?
Vasculitis refers to a group of rare diseases that cause inflammation in blood vessels, including arteries, veins, and capillaries. The inflammation can cause the walls of the affected blood vessels to thicken, reducing the width of the passageway and potentially leading to restricted blood flow or even blood clots.1 Without proper blood flow, organ and tissue damage can occur.
Vasculitis can be categorized in two ways: primary and secondary. Primary vasculitis has no known causes, whereas secondary vasculitis is triggered by an underlying condition.1
A vasculitis flare-up is when the symptoms suddenly worsen or appear after a period of remission. These symptoms can be similar to those experienced during the initial diagnosis, or they can be new or different. Flare-ups can be unpredictable, causing a wide range of symptoms, from joint pain and fatigue to fever and rashes.3 Recognizing the warning signs and managing triggers is essential to avoid serious complications like an aneurysm.2
Common Triggers of Vasculitis Flare-Ups
Managing vasculitis involves understanding what can trigger flare-ups. Here are some of the most common triggers and how they can impact your condition.
1. Infections
Infections are considered to be the most common cause of secondary vasculitis, and they can trigger a flare-up in two different ways:
- The infection directly damages the walls of the blood vessels, causing inflammation.4
- The infection triggers the body’s immune system to mistakenly attack its own blood vessels.4
Different types of bacterial and viral infections can trigger vasculitis flare-ups, including strep throat, salmonella, and hepatitis to name just a few.4,5
2. Medications
Certain medications — like penicillins, non-steroidal anti-inflammatory drugs (NSAIDs), and allopurinol — can trigger flare-ups. This is also known as drug-induced vasculitis (DIV). Although the cause of DIV is not completely understood, experts believe it is due to the immune system having an adverse effect to the drugs.6
3. Stress
Chronic stress has been linked to worsening autoimmune conditions.7 A study conducted by the Hospital for Special Surgery found that patients with a type of vasculitis known as granulomatosis with polyangiitis (GPA) were 19% more likely to experience a flare if they had lower mental health scores during remission. High levels of stress can prompt the release of stress hormones, like cortisol, which may trigger inflammation and contribute to a flare-up.8
4. Environmental Factors
Exposure to environmental conditions is recognized as a potential trigger for vasculitis flare-ups. Air pollution can disrupt the immune system, leading to heightened inflammation and damage to blood vessel linings.9 Airborne irritants don’t just affect the lungs; they can activate immune pathways that exacerbate autoimmune responses, making flare-ups more likely in susceptible individuals.
5. Hormonal Changes
Fluctuations in hormones, especially during and after menopause, could play a role in triggering vasculitis flare-ups. A study shows that in the early years after menopause, estrogen tends to have anti-inflammatory effects; however, as aging blood vessels begin to respond differently to estrogen, they shift toward a proinflammatory state.10 For those with vasculitis, this means that the timing of hormonal changes could influence symptom flares.
The Role of Infections in Flare-Ups
Infections are one of the most prominent triggers of vasculitis flare-ups. Certain bacteria and viruses — like hepatitis B and C, streptococcus, and even SARS-CoV-2 (the virus responsible for COVID-19) — can either trigger the onset of vasculitis or reactivate the disease in patients already in remission.4,5,11 These infections can disrupt the immune system’s normal balance, leading it to mistakenly attack healthy blood vessels.
Treating vasculitis often involves suppressing the immune system, which can actually make patients more vulnerable to infections.12 This creates a challenging cycle where infection increases inflammation, and treatment for inflammation increases infection risk.
Stress and Its Impact on Vasculitis
Stress isn’t just emotionally exhausting — it can be physically dangerous for people living with vasculitis. According to a study by the Hospital for Special Surgery, stress is linked to a higher chance of disease flare-ups, especially in patients with granulomatosis with polyangiitis (formerly called Wegener’s granulomatosis). Researchers found that patients in remission were 19% more likely to flare if their mental health scores dropped by just five points.8
When the body is stressed, it releases hormones like cortisol and adrenaline, which can lead to increased inflammation.13 For people with vasculitis, this means that stress can directly trigger flare-ups or worsen existing symptoms.
Preventive Strategies and Management
Preventing vasculitis flare-ups often involves a combination of medical management and lifestyle changes. Working closely with your ARBDA doctor to develop a personalized treatment plan for vasculitis is essential. Here are some key strategies to consider:
Medication Adherence
Taking prescribed medications as directed is crucial for managing symptoms and preventing flare-ups. In many cases, flares can be controlled with medications from your original treatment plan, including corticosteroids.2 Don’t stop taking prescribed medication without talking to your doctor first.
Monitoring and Communication
Keeping track of symptoms, triggers, and changes in your everyday health can help detect flare-ups early. Regular communication with your doctor ensures that any new or worsening symptoms are addressed promptly.
Schedule a Consultation with an ARBDA Doctor Today
Living with vasculitis can feel overwhelming — but getting expert care shouldn’t be. At ARBDA, we are committed to providing personalized care to help you manage your symptoms and live a healthier life. Our team of specialists understands the complexities of vasculitis and offers tailored treatment plans to meet your unique needs.
If you’re experiencing frequent flare-ups or struggling to manage your symptoms, it may be time to consult with one of our experienced rheumatologists in New Jersey. Take control of your health today by scheduling an appointment with ARBDA. Our compassionate team is here to support you on your journey to wellness.
1https://www.nhlbi.nih.gov/health/vasculitis
2https://www.nhlbi.nih.gov/health/vasculitis/living-with
3https://www.hopkinsvasculitis.org/vasculitis/symptoms-vasculitis/
4https://pubmed.ncbi.nlm.nih.gov/25876145/
5https://pmc.ncbi.nlm.nih.gov/articles/PMC7106215/
6https://pmc.ncbi.nlm.nih.gov/articles/PMC3573459/
7https://www.sciencedirect.com/science/article/abs/pii/S1567576923013723
8https://www.hss.edu/newsroom_stress-triggers-vasculitis-flares.asp
9https://pubmed.ncbi.nlm.nih.gov/36333001/
10https://pubmed.ncbi.nlm.nih.gov/22679310/
11https://www.neurology.org/doi/10.1212/WNL.96.15_supplement.4302
12https://vasculitisfoundation.org/education/immunity-and-infection/
