Prevalence of Vasculitis among Chronic Venous Insufficiency Patients Attending a Tertiary Care Centre, Tamil Nadu, India: A Descriptive Observational Study

Abstract

Introduction: Chronic Venous Insufficiency (CVI) is a relatively common condition seen worldwide and also in the Indian population. Vasculitis is a heterogenous group of disorders that affects and destroys blood vessels by inflammation. While both are separate disease entities, the presence of vasculitis in patients who present with CVI often goes unnoticed, thereby complicating the treatment of varicose veins. Aim: To determine the clinical profile and prevalence of vasculitis among patients with CVI attending a tertiary care hospital in India. Materials and Methods: This descriptive study was carried out in the Department of General Surgery among 162 patients (out of which 130 were selected based on inclusion criteria) with CVI attending tertiary care centre in Tamil Nadu, India, from February 2018 to January 2019. Patients with an active or healed ulcer on the long and short saphenous vein of lower limbs were included in the study. They were studied to assess the prevalence of vasculitis among them and the implications it had on the overall morbidity of the patient and their treatment outcome. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency, and proportion for categorical variables. Results: The mean age of the study population was 45.52 years. Out of 130 patients, 33.08% and 23.85% of the study population were diagnosed with Type 2 Diabetes Mellitus (T2DM) and systemic hypertension respectively. Only 3 (2.3%) participants had vasculitis and all of them were smokers and had a painful ulcer, fever, elevated C Reactive Protein (CRP), elevated Erythrocyte Sedimentation Rate (ESR), and elevated total leukocyte count levels. Two (66.7%) of them had an active ulcer at the time of presentation, against 1 (33.3%) who had a healing ulcer. All patients were cured by Bisgaard’s regimen + steroids/no steroids + surgery. Conclusion: The prevalence of vasculitis was 2.3%. This study confirms that patients suffering from CVI may be at a marginal risk of having co-existing vasculitis which may complicate the clinical picture and result in postoperative complications if left unchecked.