About Vasculitis

Hypersensitivity Vasculitis

Dr Richard Watts

Consultant Rheumatologist , Ipswich Hospital

This document was updated in August 2016

Download this page as a PDF

What is Hypersensitivity Vasculitis?

Hypersensitivity vasculitis (HV) is a term often used to describe many different conditions. Most commonly the term is applied to a vasculitic skin rash caused by sensitivity to a drug although it may be seen in association with several other conditions. Most commonly only the skin is affected although the bowels, kidneys and joints may also be affected.

Who are affected?

HV usually affects adults, and much less commonly children.

What are the symptoms?

The commonest symptoms are those related to the skin. Several different types of rash are recognised as HV. The commonest types of rash are small or large raised purpled spots and flat red areas. Symptoms in the skin include burning, pain or itching or the rash may not have any symptoms. Joint involvement may cause painful joints.

Bowel involvement may cause a variety of symptoms including abdominal pain and diarrhoea. Kidney involvement may lead to blood in the urine or kidney failure.

What is the aetiology (cause)?

No cause for HV is found in between one third and one half of patients. HV can be caused by a specific drug or by infection. The most common drugs include: antibiotics (particularly penicillin), non-steroidal anti-inflammatory drugs (NSAIDS) and diuretics. Infections which may be associated with HV include: hepatitis B or C virus, chronic infection with bacteria or HIV. HV type rashes and symptoms may also be seen as part of other inflammatory diseaseincluding other types of vasculitis, systemic lupus erythematosus (SLE), rheumatoid arthritis, Sjögren's syndrome, inflammatory bowel disease and very rarely some types of cancer.

Making a diagnosis

There are no specific tests for HV. Blood tests may show evidence of inflammation. Tests are usually performed to determine if the patient has one of the diseases or infections listed in the section above. If a new drug has been recently started it may suggest that this has caused the HV. Sometimes a skin biopsy is necessary to prove that there is a vasculitis.

Treatment

If drugs are implicated as the cause then the drugs should be stopped. Where infection is the cause treatment of the infection is required. If another inflammatory disease is the cause this should be treated appropriately. Patients with skin rash and joint disease may respond to dapsone or colchicine. Some patients, particularly those with severe kidney or bowel involvement, may require treatment with steroids and other immunosuppressant drugs.

Drugs and side effects

For information on the main drugs prescribed for Hypersensitivity Vasculitis see:

For information on other drugs used in the treatment of vasculitis see Glossary of drugs and side effects.

Prognosis

For patients with HV caused by an identified drug or treatable infection the prognosis is good and the disease may not recur. For patients with other underlying inflammatory diseases, chronic infections, cancers and for where no cause is found the prognosis may depend on the underlying disease and the condition may recur.

Key points

  • HV is usually caused by medications or other underlying diseases.
  • Treatment and prognosis depend on identifying the causative factors where possible.

Related Vasculitis Articles

eurordis logo

News

An App to Support Vasculitis Patients and Research

21 Sep 2017

New app to help Vasculitis manage their condition

Emotions, Relationships and Sexuality

21 Sep 2017

100-page booklet available online or in print

Art Inflammation and the Illness Experience - Shanali Perera

09 Sep 2017

Shanali Perera gave a presentation at the the Spring Vasculitis Education Day in March 2017

Events

Gill's 40 Things At 40!

01 Oct 2017

40 Things in aid of VUK

Cardiff Half Marathon

01 Oct 2017

Running for Vasculitis UK

Vasculitis Support Group West Midlands

08 Oct 2017

The West Midlands Support Group are meeting on 8 October

Chester Marathon

08 Oct 2017

Michael Kingsbury is running for Vasculitis UK

Rare Disease Patient Network Meeting

18 Oct 2017

Free event in Cardiff

Copyright©2015 Vasculitis UK. All Rights Reserved.
Design & Hosting by On Screen