‘Lucky to be alive’: What is Ashton Kutcher’s vasculitis, a disease that impairs vision, hearing and movement

BBC News Brazil

Actor Ashton Kutcher, 44, revealed that he was unable to see, hear and walk because of vasculitis, an autoimmune disease.

He shared his experience with the disease on Celebrity Proof: The Challenge,” with National Geographic host Bear Grylls.

Kutcher said he was diagnosed with a type of autoimmune vasculitis, without specifying exactly which, two years ago.

“Three years ago, I had a strange and super rare form of vasculitis, which knocked my vision, my hearing and my balance down,” he said.

“You don’t really appreciate it [os sentidos] until lose. Until you understand, ‘I don’t know if I’ll be able to see again, be able to hear again, I don’t know if I’ll be able to walk again. I’m lucky to be alive,'” the actor told the show.

“Vasculitis means inflammation of the blood vessel wall. This can result in the narrowing and even closing of the vessels, which leads to a lack of blood to different organs”, explains Bruna Chu, rheumatologist and professor of Medicine at the Positivo University in Curitiba, Paraná. .

There are more than 20 types of vasculitis, and the actor did not specify which variant he suffered from, only stating that it was a rarer version of the disorder and that he suffered from severe symptoms.

Some forms of vasculitis, as explained by rheumatologist Henrique Dalmolin, from Hopital Moriah, are mild and cause easy-to-treat symptoms, such as skin lesions.

“On the other hand, others, which tend to cause more serious consequences, affect the central nervous system, lungs, kidneys, eyes and hearing system. The more involvement I have, the more serious the condition is.”

According to the doctor, in cases of vasculitis, loss of movement is usually associated with a variation that has affected the central or peripheral nervous system, which contains nerves that transmit to limbs such as legs and arms.

THE DIFFERENT TYPES OF VASCULITIS AND SYMPTOMS

The various types of vasculitis are distinguished by the size and location of the affected vessels.

“Primary vasculitides are those in which blood vessels are the main targets of the disease. There is still a classification according to the size of the vessel: large, medium, small or variable vessels”, says Chu. For these, there are no known causes.

There are also secondary vasculitis, in which there is some other health condition responsible for the condition. “It could be another autoimmune condition, secondary infection, mainly viral, such as hepatitis and even Covid-19, medications or even contact with levamisole, a component of cocaine”, exemplifies Dalmolin.

Common symptoms include skin lesions (such as purpura, hives, and rashes), fatigue, weakness, fever, joint pain, vision changes (such as pain and redness in the eyes), headache, nasal congestion and nose bleeds, lack of shortness of breath, abdominal pain, kidney problems (dark urine), weight loss and nerve problems (numbness, weakness and pain).

HOW IS VASCULITIS DIAGNOSED?

The diagnosis of different types of vasculitis is made through laboratory tests of blood and imaging.

“Diagnosis is not easy. It depends on the evaluation of symptoms, complementary tests and often we need to exclude other diseases that have similar manifestations”, explains Chu.

Kidney, liver, blood count (with antibody tests), as well as CT and MRI scans can be used, depending on the symptoms presented by each patient.

HOW IS THE TREATMENT?

Vasculitides are mostly (when there is no other secondary condition behind their appearance) chronic autoimmune diseases, that is, caused by the patient’s own organism.

The main treatment for all subtypes is the use of immunosuppressive drugs, including, depending on the case, corticosteroids, immunobiologicals or conventional immunosuppressants, which help to control the activity of antibodies that attack the blood vessels.

In Kutcher’s case, the actor said it took him about a year to recover, likely due to the severity of his symptoms. But those who are diagnosed with vasculitis need follow-up until the end of their lives.

“The response to treatment is better when the diagnosis is early, before the condition causes narrowing or closing of blood vessels”, points out Bruna Chu.

“In some cases, the most serious and refractory, a therapy called plasmapheresis can also be performed, which removes the circulating autoantibodies from the patient’s blood. But it does not offer a cure, it only helps in a certain period of time”, explains the rheumatologist. Henrique Dalmolin.

This text was published here.