Vasculitis recently entered the public forum when Actor Ashton Kutcher, best known for his role in the long-running TV series, “That ’70s Show,” revealed his diagnosis.
During an episode of “Running Wild with Bear Grylls: The Challenger,” Kutcher said he was “lucky to be alive.” He explained he had suffered from a rare form of vasculitis that severely impacted his vision, hearing and equilibrium.
Kutcher has told his fans he is fully recovered and plans to run the TCS New York City Marathon in November 2022, supporting his anti-child-traffic nonprofit, Thorn.
The 44-year-old actor, producer, entrepreneur and model said, “You don’t really appreciate it until it’s gone, until you go, ‘I don’t know if I’m ever going to be able to see again, I don’t know if I’m ever going to be able to hear again, I don’t know if I’m ever going to be able to walk again.’”
WHAT IS VASCULITIS?
I spoke with Dr. Tara Roque, a Department of Critical Care intensivist at Suburban Hospital, a Johns Hopkins Medicine campus about the condition.
“Vasculitis is an autoimmune condition where one’s own body produces cells that attack the body’s blood vessels,” explained Dr. Roque, who was recently appointed deputy medical director for the MIEMSS Critical Care Coordination Center, Maryland’s first critical care coordination center formed to assist hospitals during the pandemic.
“As a result, the blood vessels become inflamed and lose their integrity, resulting in compromised blood flow downstream,” Dr. Roque said.
According to a May 2022 article, The National Library of Medicine reported there are 30 different types of vasculitis identified that can present as a primary complaint or a secondary process due to an underlying condition.
The NLM says the cause of various vasculitis is unknown. The incidence and prevalence are impacted by several risk factors, including geographical, age, ethnicity, gender, genetic and environmental factors.
SIGNS AND SYMPTOMS OF VASCULITIS
Dr. Roque notes the signs and symptoms of vasculitis “are dependent on what type a patient develops and where in the body the inflamed blood vessels are located.” Common symptoms include:
- Fever
- Weight loss
- Joint pain
- Rashes
Dr. Roque added that more specific symptoms are linked to the downstream organ which may be affected. For instance, vasculitis that develops in the blood vessels in the lungs can present as hemoptysis or coughing up blood.
Vasculitis can present with neurologic complaints, bleeding, rash or organ failure, often with fevers, constitutional symptoms and inflammation in multiple organ systems, Dr. Robert Koval, a rheumatologist with Texas Orthopedics told Healthline. “Lab values, skin or tissue biopsies and imaging can all be helpful in diagnosing these conditions,” Dr. Koval added, noting that in the most severe forms, vasculitis can be fatal.
LONG-TERM VASCULITIS EFFECTS AND TREATMENT
The long-term side effects of vasculitis are determined by the organ affected (e.g., the brain, lungs or kidneys),” Dr. Roque said, “and how one’s body responds to treatment. For instance, polyarteritis nodosa is a vasculitis that affects medium-sized arteries in the kidneys and thus impairs kidney function.”
In general, the treatment includes immunosuppression medications, drugs that suppress the body’s immune system and block the exaggerated inflammatory response that is occurring, Dr. Roque added.
“The mainstay of immunosuppressive therapy is steroids. Some patients may respond well and develop complete resolution of their symptoms, while others require long-term treatment to control their symptoms and prevent relapses,” Dr. Roque said.
Improved therapies can usually can result in remission, or at least minimal symptoms, Dr. Koval siad.
Kutcher reported that it took him about a year to recover from the condition.
WHO IS AFFECTED BY VASCULITIS?
Studies performed in the United States and Europe show that the condition affects roughly 20-40 million people annually.
“The exact cause of vasculitis is unknown, but we do know that it is linked to certain diseases, drugs and infections,” Dr. Roque said. “Patients with Lupus or rheumatoid arthritis are at a higher risk, as are those with a history of hepatitis.”
Dr. Roque continued that the common thread is that for an unknown reason, these disease processes “stir up” the body’s inflammatory reaction within specific blood vessels.
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