What are the common complications of systemic vasculitis that I should monitor for in my patients?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Common complications of systemic vasculitis to monitor in patients include:

  • Organ ischemia and infarction: Due to vessel inflammation and occlusion, leading to tissue damage in affected organs such as kidneys, lungs, and peripheral nerves .
  • Renal impairment: Particularly in small-vessel vasculitis like ANCA-associated vasculitis, which can cause rapidly progressive glomerulonephritis and chronic kidney disease .
  • Neurological complications: Peripheral neuropathy and mononeuritis multiplex from nerve ischemia are common and require monitoring .
  • Respiratory involvement: Pulmonary hemorrhage and interstitial lung disease can occur, especially in granulomatosis with polyangiitis, necessitating vigilance for respiratory symptoms .
  • Cardiovascular complications: Including myocarditis, pericarditis, and increased risk of accelerated atherosclerosis due to chronic inflammation .
  • Infections: Secondary to immunosuppressive therapy used in vasculitis management, increasing susceptibility to opportunistic infections .
  • Medication-related toxicity: Monitoring for adverse effects of corticosteroids and cytotoxic agents is essential .

Imaging modalities can assist in detecting vascular inflammation and complications early, supporting clinical monitoring .

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