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Old 11-19-2007, 02:39 PM #1
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Default Vasculitis question

Just wondering: what specialty of doctor typically diagnoses vasculitis? I am talking about the skin kind that can occur with Sjogren's syndrome. This is something I'm thinking I need to either rule out or confirm, or at least discuss with an expert.

I went to a dermatologist in 2004 because of skin rashes. I asked him about the weird dark red spots on my legs. He said it was petechia, but when I've mentioned this to other doctors, no one ever followed up on it.

If I do have vasculitis, couldn't that be causing or at least contributing to the neuropathy? Trying to cover all reasonable bases here.

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Old 11-19-2007, 03:05 PM #2
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(I have to do a chuckle here)....what kind of doc diagnoses vasculitis...A GOOD ONE! I would think a rheumatologist should be one of the first ones to think of it, however, that said, I have had the worst luck with rheumatologists.

A vascular doc is a likely probablility for diagnosising it, as it a good internal medicine doc. Vasculitis can be a symptom of another disease or the cause of other symptoms as a disease entity all of its own...

I believe Sjogren's manifests with vascultitis. There are many types of vasculitis, and even ones that affect just certain blood vessels, such as Temporal Arteritis or Giant Cell Arteritis. Usually sed rates are elevated with vasculitis, but other than that, I think it takes a 'sleuthing doctor' to dig deep enough to find it.

Vasculitis is autoimmune and I would think, (but I am not sure) that treating the Sjogren's would also address the vasculitis. Many connective tissue diseases (as well as many chronic diseases and their treatments cause blood vessels to become fragile.) Sjogren's has neuropathy and vasculitis as components....it may very well be that the attack of blood vessels by the immune system is the part of the pathology process of many of the collagen diseases. Blood vessels need a support system, 'collagen' and when that breaks down, the blood vessels can't get blood to the tissues, be they nerves, skin or other tissues.

Red spots on the tibial area can have a number of different causes and it seems you have several of them going on.

A solid Sjogren's diagnosis accounts for a lot of symptoms....it is a multisystem, multiorgan disease.
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Old 11-19-2007, 05:04 PM #3
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Thanks very much for the info. I'll ask the rheumatologist at Mayo when I go there in two weeks; he's a connective tissue disorder specialist. I've had bad luck with rheumatologists too over the past year.

Luckily, my major internal organs like kidneys, liver and heart are all fine, so I doubt I have to worry about vasculitis involving them if I haven't developed anything by now (I've been sick since 1997). If I do have any form of vasculitis, it is likely limited to skin and possibly blood vessels affecting peripheral nerves. My sed rate has not been consistently elevated, but my CRP has been high for most of the past seven years.

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Old 11-19-2007, 06:55 PM #4
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Wow we have the same things,interesting,bet there is more. I'm
glad wise C. has locked crying one's up. Please mention ,it in Mayo,
have you never had a ultrasound on your legs??? Just asking. hugs
Sue
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Old 11-19-2007, 07:27 PM #5
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I have vasculitis in at least, my legs. I had an area just beneath the side of my left knee that felt different than the rest of my skin. No one noticed it. I had to insist that it be biopsied and it came back positive for small vessel vasculitis. It felt somewhat more firm than the rest of the skin and was kind of white...

There are other areas on my legs with a strange appearance. My legs are shiny and reddish about top of socks high and then there are some small rounded areas that are kind of darkish red and somewhat painful. I keep showing these to every doctor I see, I including Rheumatologists.

Tomorrow, I am going to see the Rheumy and we will address this again...

Cathie
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Old 11-19-2007, 09:18 PM #6
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Default Just checked

with my local hosiptals's way of 'listing docs'?
Cardiovascular and cardiovascular disease was one category
Vascular and intervention surgery was another

Thing is, if it were ME? I'd shy away from those who specialize in 'surgery'? Those that do the testing and analyses are OK, but don't even consider surgery unless you get another TWO outside opinions to do so....And then only knowing fully all the pros and cons of any such proposed surgeries. Honestly these days I am a chicken about surgeries...Cannot imagine why?

I KNOW I have vascular damage from my CIDP onset, and probably the Hashimotos...I was on lasix for a while? All it did was really lower my blood pressure-to dangerously low?...to an uncomfortable degree. The edema I had still pops up if I strain or sprain my ankles or overdo activities. Alternating heat and cool plus an upward massage at the ankle upwards helps push excesses to a point where it gets taken out of the 'system'?

As for any and all skin rashes? This should be in the 'stickies' but here it is:

http://telemedicine.org/stamford.htm
While those of us with any PN should read the 'diabetic Neuropathies' parts...
The intro is chock full of goodies in almost 'plain language' terms about how the vascular system works....Fascinating stuff, really. It's also essential to know if you have to talk to any new doc in another non-PN field? The vascular and endo guys are going to be coming from THIS direction. Maybe not ours, but once we all get the 'terms' right we can talk more effectively. At least, that's what I've found?

BTW? I have petechiea all over, part is from meds, part is from trying to 'do' too much? part is from 'not doing enough'! Not to mention allergies and other joys? My own dermatologist looks at these skin things and goes either: You have a formisnable {HUH} and says to ignore it or I have a dornagbumble [another HUH] and prescribes a topical. The topicals help when needed, and I tune out the other stuff. Annual visits to the 'gp'? Well, that doc is the last on the food-chain these days? Doc mite ask about X or Y, but I'll reply to Doc that Derm saw it and I've been deemed 'OK'... Doc never worries, derm never worries, ergo I do not worry. Got enuf on the plate and it isn't turkey?
Hope any bit of this is useful - j
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Old 11-19-2007, 11:45 PM #7
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Default Vasculitis

These are things I've researched out:

http://vasculitis.med.jhu.edu/typesof/rheumatoid.html (from Johns Hopkin Univ.)
and another of my favorites: http://www.neuro.wustl.edu/neuromusc...tml#vasculitis

http://www.vgrd.org/archive/cases/20...tis%20text.htm

here is a tutorial about vasculitis: http://www.nlm.nih.gov/medlineplus/t...htm/lesson.htm

Behcet's syndrome vasculitis: http://www.nlm.nih.gov/medlineplus/t...htm/lesson.htm

Hope these help in some way.

Billye
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Old 11-21-2007, 04:40 AM #8
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A good genreal physician(internal medicine) or a vascular surgeon should be able to dx Vasculitis-the physican would probably be easier/quicker to access
good luck
KAren
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