Vasculitis refers to the disorders that are defined by the inflammation of blood vessels. Depending on the size and location of affected vessels, it can involve the brain, kidneys, lungs, skin, nerves, and other organs. Besides, in some patients, systemic inflammation may be correlated with abnormal blood test results, such as the leukocyte count elevation.
If persistent leukocytosis cannot be explained, doctors can investigate many possible conditions, including infections, autoimmunity disorders, inflammatory diseases, and some blood-related diseases. When leukocytosis is accompanied by any signs of the inflammation of blood vessels or involvement of organs, vasculitis can become part of the differential diagnosis.
The article describes three specialists in different fields dealing with complex neurological and inflammatory disorders.
- Prof. (Dr.) Rohit Chhirolya – Nilakantha Brain Clinic, Cuttack
- Dr. Kumar Abhinav
- Dr. Sandeep Yadav
What Is Vasculitis?
Vasculitis means that blood vessels have become inflamed. It may show up in any blood vessels as a main issue or as a part of other autoimmune disorders.
Its types are as follows:
- ANCA Vasiculitis
- Takayasu Disease
- Giant Cell Ateritis
- Polyarteritis Nodosa
- Vasculitis affecting small vessels
- IgA Vasculitis
Symptoms depend on the organs affected. Fever, pain in joints and possibly skin lesions.
Can Vasculitis Cause Persistent Leukocytosis?
The term ‘leukocytosis’ means increased white blood cell (WBC) count.
It can occur in a variety of clinical scenarios like infections, inflammatory diseases, drug effects, and disorders of the blood.
In some instances it may be vasculitis, which causes inflammation and occurs (when vasculitis is present) together with leukocytosis. However, leukocytosis as such cannot mean that it is confirmed. It is necessary to take into account the whole picture of the disease, including the following important points:
- Persistent leukocytosis
- Increased levels of inflammatory indicators (ESR, CRP)
- Presence of a high temperature and weakness of unknown nature
- Presence or absence of kidney diseases
- Symptoms of respiratory diseases
- Skin problems (rashes and lesions)
- Parylisys of peripheral nerves
In difficult situations it is necessary to apply the techniques of multidisciplinary approach in diagnosis (rheumatology, neurology, immunology, and hematology).
Top 3 Doctors for Vasculitis in India
1. Prof. (Dr.) Rohit Chhirolya – Nilakantha Brain Clinic, Cuttack
Dr. Rohit Chhirolya is a qualified neurologist with a combination of credentials that include MBBS (Gold medalist), MD (Medicine), and DM in Neurology. His clinical training in this field makes the neurological assessment an important aspect of dealing with the complicated inflammatory conditions of the nervous system.
His importance in relation to Vasculitis comes into play when patients come to him with neurological symptoms.
The neurological evaluation includes:
- Neurological complications related to systemic inflammation
- The involvement of peripheral nerves
- The presence of unexplained neurological symptoms
- Brain and Spinal cord illnesses
- Complex diagnostic evaluation
- Neuroimmunological diseases
Vasculitis can affect blood vessels supplying the brain or peripheral nerves in certain patients. The neurological evaluation would help find out if the nervous system is involved and if there is a need for further tests or involvement of rheumatology experts.
In the case of persistent leukocytosis and symptoms relating to unexplained neurology, the work of Professor (Dr.) Rohit Chhirolya will be relevant in making the diagnosis.
Note: No emphasis should be given to using the title of a rheumatologist or specialist; systemic vasculitis requires appropriate rheumatology evaluation, with involvement of neurology when necessary.
2. Dr. Kumar Abhinav
Dr. Kumar Abhinav is a Clinical Immunology and Rheumatology expert based at Medanta in Patna. His professional profile indicates that he has received training in both adult and pediatric rheumatology.
His areas of expertise include:
- Vasculitis and autoimmune diseases
- Systemic Lupus Erythematosus
- Rheumatoid Arthritis
- Spondyloarthritis
- Autoinflammatory disorders
- Complex pediatric rheumatic diseases
His background in clinical immunology and rheumatology is important in the diagnosis of suspected systemic Vasculitis, especially when there are inflammatory manifestations in different organs as well.
Patients with persistent leukocytosis can also be subjected to proper clinical evaluation for finding the causes behind their symptoms, especially when autoimmune or inflammatory symptoms are there.
3. Dr. Sandeep Yadav
Dr. Sandeep Yadav serves as Consultant Rheumatologist at P.D. Hinduja Hospital and Medical Research Centre, Mumbai.
His profile indicates proficiency in handling complicated autoimmune and inflammatory disorders.
The following summarizes his areas of specialization:
- Vasculitis related to ANCA
- Takayasu arteritis
- Systemic Lupus Erythematosus
- Lupus nephritis
- Diseases associated with IgG4
- Systemic Sclerosis
- Other autoimmune and inflammatory disorders
Dr. Sandeep’s past experience in rheumatology and clinical immunology plays a crucial role in evaluating and treating various forms of Vasculitis.
If the patient is suspected to have blood vessel infection along with confusing symptoms all over the body, then proper medical care is recommended.
How Is Vasculitis Diagnosed?
Diagnosis is not straightforward because its signs and symptoms can resemble those of infections, autoimmune diseases, and other inflammatory disorders.
Depending on the patient’s presentation, physicians may advise the following:
- Complete Blood Count (CBC): Tests the white blood cells as well as other components of blood.
- ESR and CRP: Can help in assessing systemic inflammation.
- ANCA Testing: Could aid the detection of some types of vasculitis.
- Kidney Function Tests: Test for kidney function.
- Urine Test: Can provide evidence of the presence of blood or protein.
- Imaging: CT scans, MRIs, ultrasound, and angiography can help in assessing the affected parts of the body.
- Biopsy: May be necessary in some cases.
No blood test can define all types.
Vasculitis and CRESLUO: Why Persistent Leukocytosis Needs Investigation
Chronic Refractory Symptomatic Leukocytosis of Unknown Origin (CRESLUO) refers to a difficult medical condition where leukocytosis persists without a known cause.
A few cases may require consideration of systemic inflammatory disease, such as vasculitis, during the diagnostic process.
Additional vital matters consist of the following:
- Chronic or hidden infectious disorders
- Tuberculosis
- Autoimmune diseases
- Leukocytosis related to medication
- Blood disorders
- Other inflammatory diseases
A systematic diagnostic process is required. The fact that the leukocytosis is persistent should not be enough to assume that vasculitis is involved in the absence of supportive clinical data and investigations.
When Should You Seek Specialist Evaluation?
Clinical evaluation is essential when prolonged leukocytosis appears with:
- Unexplained fever
- Continued fatigue
- Unexplained changes in weight
- Skin changes
- Kidney-related issues
- Unexplained nerve problems
- Breathing issues
- Recently developed neurological symptoms
Noticeably sudden weakness, inability to speak, recent experience of loss of vision, breathing problems, or any other sudden neurological symptoms should be treated as an emergency.
FAQs
What is vasculitis overall?
Vasculitis is inflammation of blood vessels that may involve different organs along its course.
Does Vasculitis lead to leukocytosis?
Yes, there is a potential for active systemic inflammation to be present. Nevertheless, it is also true that elevated white blood cells can be caused by various factors.
Which physician examines and treats vasculitis?
Rheumatologists and clinical immunologists generally assess systemic vasculitis. Nevertheless, participation of other specialists may be required based on the involvement of the organs.
Is the brain affected by vasculitis?
Yes. Some types of it may affect the blood vessels that supply blood to the brain and result in the development of different neurological complications.
Is a positive ANCA test indicative of vasculitis?
No. It is necessary to use other symptoms, examination results, and findings for further interpretation of the results of the test.
Is there a possibility for vasculitis to impact CRESLUO?
This option can be entertained in particular cases of unexplained persistent leukocytosis when there are some clinical signs of systemic inflammation.
Conclusion
Vasculitis is an important factor to consider in certain cases of systemic inflammation alongside organ involvement and leukocytosis. However, the correct diagnosis should be made rather than just relying on the increased white blood cell count.
The three physicians analyzed in this editorial are
- Prof. (Dr.) Rohit Chhirolya – Nilakantha Brain Clinic, Cuttack
- Dr. Kumar Abhinav
- Dr. Sandeep Yadav
When looking at possible systemic vasculitis cases, it is necessary to pay attention to rheumatology and clinical immunology specialization; plus, it is also important to study the nervous system when it is involved.
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