- Frequency (Last update 11 February 2010)
- Relapses are always possible and unpredictable but some appear to be due to excessive stress. Some AV patients have long lasting remissions; others have more frequent relapses.
- Be vigilant about new symptoms, or increased current symptoms. When in doubt, inform your team leader or rheumatologist.
- Avoid excessive stress, both physical and emotional.
- Avoid infections.
- WG patients and perhaps others may benefit from Bactrim or other antibiotics prophylactically.
- Exercise done in moderation can be an important to maintain bone and muscle strength as long as done with the physician's approval.
- Prednisone weakens tendons and muscles, so excessive stress must be avoided while on prednisone.
- Some medications used in remission maintenance are listed in the following table:
|Methotrexate||RCT||Standard agent for patients without renal involvement|
|Mycophenolate mofetil||Case series||Alternative to azathioprine|
|Co-trimoxazole||RCT||Reduced risk of respiratory tract infections and respiratory tract relapses|
|Deoxyspergualin||Case series||Not available outside Japan for clinical use|
|Cyclophosphamide||Case series||High rate of complications with long-term use; no longer considered acceptable for use as a remission-maintenance agent|
- Usually relapses will present in the same ways as at the onset of the AV.
- Sometimes, entirely new symptoms will occur. That makes it difficult to know for sure there's a relapse.
- While periodic blood and urine test results may show elevated levels, relapse doesn't always happen.
- Always inform your physicians when previous or new symptoms become evident.
- When to treat
- Catching a relapse early and treating it aggressively may prevent more serious AV activity.
- Most physicians experienced in treating AVs will not treat for relapse based sole on blood test results.
- If major organs are involved in the recurrent or new symptoms, aggressive treatment could be considered.
- Changing meds
- Sometimes, prednisone is prescribed and if effective, can help make the determination of relapse.
- At times a patient will relapse if the immunosuppressive is not effective enough.
- A change to a different immunosuppressive can sometimes be effective.
- Cyclophosphamide is usually the last resort for a non-biological IS.
- There have been cases where cyclophosphamide was ineffective, but a different IS was effective.
- After remission
- Click here to see "Life-long treatment"ť above under sub-heading "Scheduled tests" in the section, "VASCULITIS INTRO".
- Kidneys can continue to improve in function as long as a year after remission
- To assist vasculitis patients in getting early diagnoses, effective treatments, and to advise of patient, organization, and scientific resources concerning vasculitis.
- Sources Used
- The following information is derived from a variety of sources over some ten+ years and is not to be considered as medical advice, but merely the opinions or experiences or findings of the writer who is not a physician and has no medical training.
- Much comes from Medline abstracts and medical journal articles on vasculitis.Â Some is from autoimmune vasculitis patients and carers, some from newsgroups,Â internet web pages, etc. that also deal with vasculitis.
- The compiler has attempted to use only recent valid medical information regarding vasculitis, but cannot guarantee the validity nor the currency in every case
- No medical decisions should be made on the basis of information on this web page or on associated linked documents and web pages unless those are from a recognized medical professional or professional medical publication.
- Limits to this web page concerning vasculitis:
- The author/compiler/editor of this web page and related pages has had NO medical training.
- Only autoimmune vasculitides will be considered, not hypersensitivity vasculitis nor vasculitis as a result of an allergic reaction to medication or vaccine..
- Most sections apply to most autoimmune vasculitides.
- One refers specifically to Wegenerâ€™s granulomatosis.
- Some abbreviations and equivalencies are:
- Hereafter, â€śautoimmune vasculitisâ€ť may be abbreviated â€śAVâ€ť or â€śAVsâ€ť for plural.
- The term â€śPrednisoneâ€ť is sometimes used where it or a similar glucocorticoid might be prescribed to treat vasculitis.
- â€śImmunosuppressivesâ€ť used toÂ treat vasculitis are sometimes abbreviated â€śISsâ€ť.
- Some abbreviations and equivalencies are:
- This update was on June 1, 2009 and is a complete rewrite of the former web page at http://www.wegenersgranulomatosis.net that also dealt with vasculitis.
- Files & links â€“ Vasculitis related.
- Tables & Figures â€“ Vasculitis related
- ALL MEDICAL QUESTIONS, SYMPTOMS, CONCERNS AND PROBLEMS SHOULD BE DIRECTED TO APROPRIATE LICENSED MEDICAL PROFESSIONALS.
- The writer/editor/compiler does not vouch for the accuracy, completeness, nor applicability of the information included on this site to any person, whether a vasculitis patient or otherwise.Â