Dr. Abhijeet Bhosikar

Vasculitis Treatment in Pune & Pimpri-Chinchwad

The one group in rheumatology where days of delay cost sight, kidneys or life.

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Ravet, Pimpri-Chinchwad · OPD Mon, Wed, Fri

Gloved hands drawing medication from a vial in a laboratory settingIllustrative

Overview

What this group of conditions has in common

Vasculitis means inflammation of blood vessel walls. The vessel narrows or blocks, and the tissue it supplies is starved. Which organ fails depends entirely on the size and location of the vessels involved.

Large-vessel disease includes Takayasu arteritis — diagnosed considerably more often in India than in the West, typically in women under 40 — and giant cell arteritis in older adults. Small-vessel disease includes the ANCA-associated vasculitides, which threaten the kidneys and lungs.

This is the genuine emergency of the speciality. Untreated giant cell arteritis can cause irreversible blindness within days. Untreated ANCA vasculitis can destroy kidney function within weeks. Suspected cases are not booked for next month.

Early morning sunlight over an open fieldIllustrative
Vitamin D deficiency is widespread in India despite abundant sunlight — indoor work, covering clothing and air pollution all contribute.

Recognising it

The clues that point to this group

Pattern recognition does more diagnostic work in rheumatology than any single test. These are the features that matter here.

  • Unexplained systemic illness

    Persistent fever, night sweats, weight loss and fatigue with no infective cause found, often for weeks before anyone connects it.

  • Organ-specific alarm signs

    New headache with scalp tenderness or jaw pain on chewing; unequal pulses or arm claudication; a non-blanching purpuric rash; nasal crusting with bloody discharge.

  • Infection must be excluded first

    In India, tuberculosis, infective endocarditis and deep fungal infection mimic vasculitis closely. Excluding them before high-dose immunosuppression is mandatory, not optional.

  • Relapse risk is high

    Maintenance therapy runs 24–48 months, and follow-up continues even when the patient feels entirely well — particularly with PR3-ANCA disease.

Investigation

The tests that separate these conditions

Only the investigations that answer a specific question — plus the safety screening required before any immunosuppression.

  • ANCA with PR3 and MPO

    Immunofluorescence plus specific ELISA — these define the subtype and predict both treatment intensity and relapse risk.

  • Urgent urine microscopy

    Dysmorphic red cells and casts indicate active glomerulonephritis. This simple test often determines the urgency of everything else.

  • Vascular imaging

    CT or MR angiography and PET-CT for large-vessel disease; temporal artery Doppler for the halo sign in giant cell arteritis.

  • Tissue biopsy

    Kidney, skin, nerve, lung or temporal artery. Histology guides how hard to treat and avoids treating the wrong disease.

  • TB and endocarditis screening

    Before any high-dose immunosuppression — the mimics here are dangerous to miss.

Treatment

How this is treated, step by step

A defined sequence with a defined review point at each stage — not an open-ended prescription.

  1. 01

    Treat first if sight is at risk

    In suspected giant cell arteritis with visual symptoms, high-dose steroids start immediately — before biopsy. Delay costs sight permanently.

  2. 02

    Exclude the mimics

    TB, endocarditis and deep fungal infection screened in parallel, not afterwards.

  3. 03

    Remission induction

    Rituximab or cyclophosphamide with steroids for organ-threatening ANCA disease; plasma exchange in selected severe cases.

  4. 04

    Spare the steroids

    Tocilizumab in giant cell and Takayasu arteritis; avacopan in ANCA vasculitis. Both cut cumulative steroid exposure substantially.

  5. 05

    Maintain and protect

    Scheduled rituximab, azathioprine or methotrexate for two to four years, with Pneumocystis prophylaxis, TB screening and full vaccination.

Conditions in this group

1 conditions treated under vasculitis

Each has a full patient guide covering symptoms, diagnosis, treatment and the warning signs that need urgent attention.

  • Vasculitis

    Vasculitis

    Inflammation of blood vessels — where days of delay can cost sight, kidneys or life.

    Read the guide

Do not wait for an appointment if you have

  • Any sudden visual loss or transient blurring in a patient over 50 with headache — same-day emergency
  • Coughing up blood or rapidly worsening breathlessness
  • Rapidly rising creatinine or visibly bloody urine
  • New foot drop or wrist drop
  • Blackening of fingers or toes

Call the clinic on +91 70571 19999 or attend the nearest emergency department.

Questions

FAQs — vasculitis

Is vasculitis curable?
Many forms achieve sustained remission with modern induction and maintenance therapy, and some patients eventually come off all treatment. Relapse is common enough that long-term follow-up remains necessary even when someone feels completely well.
Why so many tests before treatment starts?
Because the treatment is powerful immunosuppression and several serious infections — tuberculosis and endocarditis especially — mimic vasculitis. Getting the diagnosis right before suppressing the immune system is a safety requirement. The exception is threatened vision, where steroids start immediately.
Is Takayasu arteritis common in India?
It is diagnosed considerably more often here than in Western countries, typically in women under 40. Unequal pulses, unexplained hypertension in a young woman, or arm pain on exertion should prompt evaluation.

Also treated

Other treatment areas

Get a specialist opinion on vasculitis

Consultations at the Ravet clinic in Pimpri-Chinchwad. Bring your previous reports — a properly reviewed history usually saves repeating tests.

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