AAV & Specialists: Neurologists, Eye Doctors & More | Everyday Health

When diagnosed with ANCA-associated vasculitis (AAV), a complex autoimmune disease involving inflammation of blood vessels, a primary care physician and rheumatologist are often the first line of defense. However, depending on which organs are affected, a team of specialists may be needed to effectively manage the condition and prevent long-term complications. Early and comprehensive care is crucial for those living with AAV.

Neurological Involvement and the Role of a Neurologist

AAV can sometimes cause inflammation of the small blood vessels connected to the nervous system. In these cases, a neurologist becomes an essential part of the care team. These specialists address issues related to the brain and spinal cord, and patients may experience symptoms such as weakness, difficulty walking, or a tingling sensation – often described as “pins and needles” – in the hands and feet.

The prevalence of neurological symptoms varies depending on the specific type of AAV. Up to 70 percent of individuals with eosinophilic granulomatosis with polyangiitis (EGPA) and those with microscopic polyangiitis (MPA) may experience these neurological manifestations.

Protecting Vision with an Ophthalmologist

Eye and vision problems are common in AAV, affecting approximately half of those diagnosed with granulomatosis with polyangiitis (GPA), and can occur in other AAV types as well. Symptoms can include painful redness in the eyes, blurred vision, and inflammation within the layers of the eye, such as uveitis. An ophthalmologist is crucial for prompt diagnosis and treatment to prevent permanent vision loss.

Addressing Skin Manifestations with a Dermatologist

Skin rashes and discoloration are frequently observed symptoms of AAV, making a dermatologist a valuable member of the treatment team. Dermatologists not only treat existing skin conditions but also specialize in diagnosing and treating diseases affecting the hair and nails. Approximately a quarter of people with AAV may develop some form of skin lesion.

These skin issues can be indicative of a more widespread underlying health problem. A dermatologist will collaborate with the patient and the broader care team to determine the root cause and develop an appropriate treatment plan.

Vascular Surgery for Complications

In certain cases, surgery may be necessary to repair blood vessels damaged by AAV. However, vascular surgery is typically not used to address the underlying inflammatory process itself. Instead, it’s reserved for situations where vascular damage has already occurred and is causing significant complications.

According to Daniel Torrent, MD, MPH, a vascular surgeon at Longstreet Clinic in Gainesville, Georgia, surgical intervention is usually considered when AAV is more severe. “Surgical intervention is typically reserved for organ- or limb-threatening complications, such as critical arterial stenosis, ischemia (low blood flow), aneurysm formation with risk of rupture, or thrombosis,” he explains.

The timing of surgery is also important. Dr. Torrent emphasizes that vascular surgeons will repair damaged blood vessels only after the inflammation has been brought under control. This ensures the best possible outcome for the patient.

Effective management of AAV often requires a collaborative approach involving multiple specialists. Starting care soon after diagnosis is vital to manage the condition effectively and minimize the risk of long-term complications. The specific specialists involved will depend on the individual’s symptoms and the organs affected by the disease.