CNS vasculitis: TreatmentCCNS vasculitis: TreatmentCNS vasculitis: TreatmentEnglishHaematologyChild (0-12 years);Teen (13-18 years)BrainArteries;Veins;Capillaries;BrainDrug treatmentCaregivers Adult (19+)NA2009-11-06T05:00:00ZSusanne Benseler, MD;Holly Convery, RNEC, BScN7.0000000000000066.00000000000001719.00000000000Health (A-Z) - ProcedureHealth A-Z<p>​CNS vasculitis is treated with a combination of medications that reduce inflammation and suppress immune function. Learn about CNS vasculitis treatment. </p><h2>What is CNS vasculitis?</h2> <p><a href="/Article?contentid=914&language=English">CNS vasculitis</a> is an inflammation of blood vessels in the brain. Blood vessels are the veins and arteries that carry blood around the body. In CNS vasculitis, the immune system mistakes normal cells in the blood vessels for harmful intruders and attacks them. This makes the blood vessel walls swell and get thicker. </p> <p>CNS vasculitis can harm the brain. When the blood vessels are inflamed, less blood can flow through them. This means that the brain tissue around the inflamed blood vessels may be damaged, or it may not get enough oxygen. If CNS vasculitis is not treated, it can cause permanent damage. </p> <p>The treatment of CNS vasculitis aims to:</p> <ul> <li>improve the blood supply to the brain<br></li> <li>prevent further complications<br></li> <li>prevent blood clots from forming. </li> </ul><h2>Key points</h2> <ul> <li>CNS vasculitis is treated with medicine to suppress the immune system and prevent blood clots. Treatment takes about two years. </li> <li>While your child is being treated for CNS vasculitis, it is important to prevent infection and talk to your doctor about any side effects. </li> <li>You know your child best. Tell your child's doctor about any changes in behaviour or anything that seems unusual or important. </li> </ul><h2>Treatment for CNS vasculitis takes about two years</h2> <p>Treatment for CNS vasculitis is a slow process. The entire treatment plan takes at least two years.</p> <p>Not all types of childhood CNS vasculitis are treated the same way. Different children will need different medicines for different amounts of time. If the CNS vasculitis symptoms flare up, the doctors may decide to treat your child for longer. If the treatment works fast, the doctors will give less medicine. </p> <h3>Progressive large vessel CNS vasculitis and small vessel CNS vasculitis</h3> <p>Children with small vessel or progressive large vessel CNS vasculitis are usually treated in two stages:</p> <ul> <li>In the first stage, your child will take high doses of strong medicine. This is called the induction stage. The goal is to rescue the brain by treating the severe inflammation in your child's blood vessels. Your child will start with high doses of prednisone. The doctor will slowly lower the dose over the next nine months. </li> <li>Your child may also take cyclophosphamide. If so, they will take it every month for the first six months. </li> <li>In the second stage, your child will take a gentler combination of medicines for another 18 months. This is called the maintenance stage. The aim during this stage is to help stop CNS vasculitis from coming back while your child's brain is healing. The medicines are usually azathioprine or mycophenolate mofetil, plus low doses of prednisone. </li> </ul> <p>This type of treatment is called an induction-maintenance strategy.</p> <p>At the same time, your child will take a blood thinner to prevent blood clots.</p> <h3>Non-progressive CNS vasculitis</h3> <p>Children with non-progressive CNS vasculitis are usually treated with a high dose of prednisone for three months. Then your child will take smaller and smaller doses of prednisone over the next months. Taking smaller and smaller doses is called tapering.</p> <p>At the same time, your child will take a blood thinner to prevent blood clots.</p><h2>CNS vasculitis is treated with medicine</h2> <p>Your child will need to take different kinds of medicine for CNS vasculitis:</p> <ul> <li>Medicine to suppress the immune system and reduce the inflammation in the blood vessel walls. This includes prednisone, <a href="/Article?contentid=113&language=English">cyclophosphamide</a>, azathioprine and mycophenolate mofetil. </li> <li>Medicine to make the blood thinner and prevent blood clots. This includes low-dose <a href="/Article?contentid=77&language=English">ASA (acetylsalicylic acid)</a> and heparin. </li> </ul> <p>Your child will be taking these medicines for many months. You need to know about them and about the side effects that your child may have. These are described in more detail below. </p> <p>If you are worried about any side effects, talk to your child's doctor.<br></p> <h2>Heparin</h2> <p>Children with large vessel CNS vasculitis often take intravenous (IV) heparin at first. Intravenous means your child will take this medicine through a needle or a tube that puts it directly into their bloodstream. </p> <p>Later, your child may take low molecular weight heparin (LMWH). This medicine is given with a needle under your child's skin.</p> <h2>Acetylsalicylic acid (ASA)</h2> <p>If your child has large vessel CNS vasculitis, they will also take <a href="/Article?contentid=1173&language=English">ASA (acetylsalicylic acid)</a> for the whole time they are being treated. ASA makes your child's blood thinner. This helps your child's blood travel through the blood vessels. </p> <p>Your child will take a very low dose of ASA, between 2 and 5 mg per kilogram of body weight per day. At this dose, ASA has no major side effects. Some children may have an upset stomach. </p> <h2>Prednisone</h2> <p><a href="/Article?contentid=221&language=English">Prednisone</a> is a drug that suppresses the immune system. This means that it lowers the number of immune cells that are attacking your child's blood vessels. When your child takes prednisone for a long time, the immune system is able to "reset" itself and make a new set of healthy immune cells. The new immune cells will not attack your child's body. </p> <p>Your child will be taking a high dose of prednisone to start with. As the treatment goes on, the doctor will lower the dosage.</p> <p>Your child needs to take the amount of prednisone that the doctor prescribes. This is very important. If your child is taking high doses of prednisone and then suddenly stops, your child's body will not be able to adjust to the change. </p> <p>The side effects of prednisone are not pleasant, but there is no other way to treat CNS vasculitis. The effects are stronger at higher doses and with longer courses of treatment. The main side effects are: </p> <ul> <li>weight gain </li> <li>more risk of getting infections </li> <li>hair growth </li> <li>stretch marks </li> <li>acne </li> <li>mood swings </li> <li>upset stomach </li> <li>higher blood pressure </li> <li>higher blood sugar </li> <li>thinning bones (osteoporosis) </li> </ul> <p>These side effects are all temporary. They will go away as soon as your child stops taking the prednisone.</p> <h2>Cyclophosphamide</h2> <p><a href="/Article?contentid=113&language=English">Cyclophosphamide</a> also suppresses the immune system. It slows down or stops the growth of immune system cells. Your child will take cyclophosphamide once a month through an IV tube. </p> <p>Cyclophosphamide is also used to treat some kinds of cancer. But we use much lower doses for CNS vasculitis. This means that CNS vasculitis patients have fewer side effects than cancer patients. </p> <p>For children with CNS vasculitis, cyclophosphamide has three main side effects:</p> <ul> <li>more risk of getting infections </li> <li>more risk of bleeding </li> <li>upset stomach and vomiting (throwing up) </li> </ul> <p>A very large dose of cyclophosphamide can make it hard for girls or boys to have children later on. We will watch your child's treatment to make sure they do not reach this dose.</p> <h2>Azathioprine (Imuran)</h2> <p><a href="/Article?contentid=80&language=English">Azathioprine</a> also suppresses the immune system. It stops immune system cells from dividing.</p> <p>Common side effects include:</p> <ul> <li>stomach upset </li> <li>diarrhea </li> <li>allergic reactions </li> <li>a flu-like illness </li> <li>liver irritation </li> </ul> <p>To watch for problems, your child will need a blood test every month.</p> <p>Some people cannot remove azathioprine from their bodies. Before your child starts taking this medicine, they will need a blood test to find out if they can take it safely. </p> <h2>Mycophenolate mofetil (Cellcept)</h2> <p><a href="/Article?contentid=195&language=English">Mycophenolate mofetil (MMF)</a> also suppresses the immune system. It stops immune system cells from getting overactive.</p> <p>The most common side effect is stomach upset. To prevent this, your child should take the medicine with food.</p> <p>A more serious side effect is when MMF stops the body from making white blood cells, red blood cells and platelets. To watch the levels of these blood cells, your child will need regular blood tests. </p>
Vasculite du système nerveux central : TraitementVVasculite du système nerveux central : TraitementCNS vasculitis: TreatmentFrenchHaematologyChild (0-12 years);Teen (13-18 years)BrainArteries;Veins;Capillaries;BrainDrug treatmentCaregivers Adult (19+)NA2009-11-06T05:00:00ZSusanne Benseler, MD;Holly Convery, RNEC, BScN7.0000000000000066.00000000000001719.00000000000Health (A-Z) - ProcedureHealth A-Z<p> La vasculite du SNC se traite grâce à une combinaison de médicaments pour réduire l’inflammation et supprimer la fonction immunitaire.<br></p><h2>Qu’est-ce qu’une vasculite du système nerveux central?</h2><p>La vasculite du SNC est une inflammation des vaisseaux sanguins du cerveau. Les vaisseaux sanguins comprennent les veines et les artères, et ils servent à transporter le sang partout dans le corps. En cas de la vasculite du SNC, le système immunitaire confond les cellules normales dans les vaisseaux sanguins et les prend pour des envahisseurs dangereux et les attaque. Les parois des vaisseaux sanguins gonflent alors et s’épaississent.</p><p>Une vasculite du SNC peut endommager le cerveau. Lorsque les vaisseaux sanguins sont enflammés, une moins grande quantité de sang peut y circuler. Cela signifie que les tissus autour des vaisseaux sanguins enflammés peuvent être endommagés ou ne pas recevoir suffisamment d’oxygène. Si une vasculite du SNC n’est pas traitée, elle peut entraîner des dommages permanents.</p><p>Le traitement d’une vasculite du SNC vise à :</p><ul><li>améliorer l’approvisionnement en sang au cerveau,<br></li><li>éviter les complications,</li><li>éviter la formation de caillots sanguins.</li> </ul><br><h2>À retenir</h2> <ul> <li>La vasculite du SNC est traitée avec des médicaments pour supprimer le système immunitaire et éviter la formation de caillots sanguins. Le traitement prend environ deux ans.</li> <li>Pendant que votre enfant sera traité pour une vasculite du SNC, il est important d’éviter les infections et de parler à votre médecin des effets secondaires qui peuvent se présenter.</li> <li>Vous êtes la personne qui connaît le mieux votre enfant. Mentionnez au médecin de votre enfant tout changement de comportement ou tout ce qui peut sembler inhabituel ou important.<br></li> </ul><h2>Le traitement de la vasculite du SNC prend environ deux ans</h2> <p>Le traitement de la vasculite du SNC est un lent procédé. Le traitement complet prend au moins deux ans.</p> <p>Tous les types de vasculite du SNC chez les enfants ne sont pas traités de la même façon. Différents enfants devront prendre différents médicaments pendant des périodes différentes. Si les symptômes de vasculite du SNC s’aggravent, les médecins pourront décider de traiter plus longtemps votre enfant. Si le traitement fonctionne rapidement, les médecins donneront moins de médicaments.</p> <h3>Vasculite du SNC progressive de grands vaisseaux et vasculite du SNC de petits vaisseaux</h3> <p>Les enfants atteints de vasculite du SNC de petits vaisseaux ou progressive de grands vaisseaux sont habituellement traitées en deux étapes :</p> <ul> <li>Pour la première étape, votre enfant devra prendre des doses élevées de médicaments très forts. On appelle cela l’étape d’induction. Le but consiste à récupérer le cerveau en traitant l’inflammation grave des vaisseaux sanguins de votre enfant. Votre enfant commencera avec des doses élevées de prednisone. Le médecin diminuera ensuite graduellement la dose au cours des neuf prochains mois. </li> <li>Votre enfant pourra également prendre de la cyclophosphamide. Si c’est le cas, il en prendra tous les mois pendant les six premiers mois du traitement. </li> <li>Dans la deuxième étape, votre enfant prendra une combinaison moins forte de médicaments pendant encore 18 mois. Cela s’appelle l’étape de maintien. Le but de cette étape vise à ce que la vasculite du SNC ne revienne pas pendant que le cerveau de votre enfant guérit. Les médicaments utilisés sont habituellement l’azathioprine ou le MMF, plus de faibles doses de prednisone. </li> </ul> <p>Ce type de traitement est appelé stratégie induction-maintien.</p> <p>Parallèlement, votre enfant prendra un anticoagulant pour éclaircir son sang et éviter la formation de caillots sanguins.</p> <h3>Vasculite du SNC non progressive</h3> <p>Les enfants atteints de vasculite du SNC non progressive sont habituellement traités avec une dose élevée de prednisone pendant trois mois. Ensuite, ils prennent des doses de plus en plus petites de prednisone au cours des mois qui suivent. La réduction progressive des doses s’appelle le sevrage graduel.</p> <p>Parallèlement, votre enfant prendra un anticoagulant pour éclaircir son sang et éviter la formation de caillots sanguins.</p><h2>La vasculite du SNC est traitée avec des médicaments</h2> <p>Votre enfant devra prendre différents types de médicaments pour la vasculite du SNC :</p> <ul> <li>des médicaments pour supprimer le système immunitaire et réduire l’inflammation des parois des vaisseaux sanguins; cela comprend de la prednisone, de la cyclophosphamide, de l’azathioprine et du mofétilmycophénolate,</li> <li>des médicaments pour éclaircir le sang et éviter la formation de caillots sanguins; cela comprend de l’acide acétylsalicylique (AAS), ou aspirine, à faible dose, et de l’héparine.</li> </ul> <p>Votre enfant prendra ces médicaments pendant de nombreux mois. Vous devrez les connaître ainsi que les effets secondaires que votre enfant pourrait ressentir. Ils sont décrits en détail ci-après.</p> <p>Si certains effets secondaires vous inquiètent, discutez-en avec le médecin de votre enfant.</p> <h2>Héparine</h2> <p>Les enfants atteints d’une vasculite du SNC à grands vaisseaux prennent souvent, au début, de l’héparine par intraveineuse (IV). Cela signifie que les médicaments lui sont administrés par une aiguille ou un tube qui injecte directement les médicaments dans le sang.</p> <p>Plus tard, votre enfant pourra prendre de l’héparine de faible poids moléculaire (HBPM), administrée par injections sous-cutanées (piqûre sous la peau).</p> <h2>AAS (aspirine)</h2> <p>Si votre enfant est atteint d’une vasculite du SNC à grands vaisseaux, il prendra également de l’AAS (acide acétylsalicylique ou aspirine) pendant toute la durée de son traitement. L’aspirine permet d’éclaircir le sang de votre enfant, ce qui facilite la circulation sanguine dans les vaisseaux sanguins.</p> <p>Votre enfant prendra une très faible dose d’aspirine, de 2 à 5 mg par kilogramme de son poids par jour. À cette dose, l’aspirine n’a aucun effet secondaire important. Certains enfants peuvent avoir un peu mal au ventre.</p> <h2>Prednisone</h2> <p>La prednisone est un médicament qui supprime le système immunitaire. Cela signifie qu’il diminue le nombre de cellules immunitaires qui attaquent les vaisseaux sanguins de votre enfant. Lorsque votre enfant prend de la prednisone pendant une longue période de temps, cela permet au système immunitaire de se « remettre à zéro » et de produire de nouveaux ensembles de cellules immunitaires en santé. Les nouvelles cellules immunitaires n’attaqueront pas le corps de votre enfant.</p> <p>Au départ, votre enfant prendra des doses élevées de prednisone. Au fur et à mesure du traitement, le médecin diminuera le dosage.</p> <p>Votre enfant doit prendre la quantité de prednisone que le médecin prescrit. C’est très important. Si votre enfant prend des doses élevées de prednisone puis arrête soudainement, son corps ne pourra pas s’ajuster au changement. </p> <p>Les effets secondaires de la prednisone ne sont pas agréables, mais il n’existe aucune autre façon de traiter la vasculite du SNC. Les effets sont plus forts à des doses élevées et avec des traitements prolongés. Les principaux effets secondaires associés à la prednisone sont les suivants : </p> <ul> <li>prise de poids,</li> <li>plus grand risque de contracter des infections,</li> <li>croissance du système pileux (poils et cheveux),</li> <li>vergetures,</li> <li>acné,</li> <li>sautes d’humeur,</li> <li>dérangements d’estomac,</li> <li>pression sanguine élevée,</li> <li>niveau de sucre élevé dans le sang,</li> <li>raréfaction des tissus osseux (ostéoporose).<br></li> </ul> <p>Ces effets secondaires sont tous temporaires. Ils disparaîtront dès que votre enfant aura cessé de prendre de la prednisone.</p> <h2>Cyclophosphamide</h2> <p>La cyclophosphamide supprime également le système immunitaire. Elle ralentit ou arrête la croissance de cellules du système immunitaire. Votre enfant prendra de la cyclophosphamide une fois par mois par tube intraveineux.</p> <p>La cyclophosphamide sert également à traiter certains types de cancers. Mais nous utilisons des doses beaucoup plus faibles pour la vasculite du SNC. Cela signifie que les patients atteints de vasculite du SNC ont moins d’effets secondaires que ceux atteints de cancer.</p> <p>Dans le cas d’enfants atteints de vasculite du SNC, la cyclophosphamide présente trois principaux effets secondaires :</p> <ul> <li>un risque accru de contracter des infections,</li> <li>un risque accru de saignements,</li> <li>dérangements d'estomac et vomissements. </li> </ul> <p>Une forte dose de cyclophosphamide peut aussi faire en sorte qu’il sera plus difficile d’avoir des enfants lorsque les enfants traités seront grands. Nous surveillerons le traitement de votre enfant pour nous assurer de ne pas atteindre cette dose.</p> <h2>Azathioprine (Imuran)</h2> <p>L’azathioprine supprime également le système immunitaire. Il empêche la division cellulaire des cellules du système immunitaire.</p> <p>Les effets secondaires courants sont les suivants :</p> <ul> <li>dérangement d’estomac,</li> <li>diarrhée,</li> <li>réactions allergiques,</li> <li>maladie semblable à la grippe,</li> <li>irritation du foie.</li> </ul> <p>Pour contrôler qu’aucun problème ne se déclare, votre enfant devra subir tous les mois une analyse sanguine.</p> <p>Certaines personnes n’arrivent pas à éliminer l’azathioprine de leur corps. Avant que votre enfant prenne ce médicament, il devra subir une analyse sanguine pour savoir s’il peut le prendre en toute sécurité.</p> <h2>Mofétilmycophénolate (CellCept ou MMF)</h2> <p>Le MMF supprime également le système immunitaire. Il empêche les cellules du système immunitaire d’être trop actives.</p> <p>Son effet secondaire le plus courant est le dérangement de l’estomac. Pour éviter que cela se produise, votre enfant devrait prendre ce médicament en mangeant.</p> <p>Un effet secondaire plus grave du MMF est lorsqu’il empêche le corps de produire des globules blancs, des globules rouges et des plaquettes. Pour surveiller le niveau de ces cellules sanguines, votre enfant devra subir des analyses sanguines régulières. <br></p>

 

 

CNS vasculitis: Treatment1173.00000000000CNS vasculitis: TreatmentCNS vasculitis: TreatmentCEnglishHaematologyChild (0-12 years);Teen (13-18 years)BrainArteries;Veins;Capillaries;BrainDrug treatmentCaregivers Adult (19+)NA2009-11-06T05:00:00ZSusanne Benseler, MD;Holly Convery, RNEC, BScN7.0000000000000066.00000000000001719.00000000000Health (A-Z) - ProcedureHealth A-Z<p>​CNS vasculitis is treated with a combination of medications that reduce inflammation and suppress immune function. Learn about CNS vasculitis treatment. </p><h2>What is CNS vasculitis?</h2> <p><a href="/Article?contentid=914&language=English">CNS vasculitis</a> is an inflammation of blood vessels in the brain. Blood vessels are the veins and arteries that carry blood around the body. In CNS vasculitis, the immune system mistakes normal cells in the blood vessels for harmful intruders and attacks them. This makes the blood vessel walls swell and get thicker. </p> <p>CNS vasculitis can harm the brain. When the blood vessels are inflamed, less blood can flow through them. This means that the brain tissue around the inflamed blood vessels may be damaged, or it may not get enough oxygen. If CNS vasculitis is not treated, it can cause permanent damage. </p> <p>The treatment of CNS vasculitis aims to:</p> <ul> <li>improve the blood supply to the brain<br></li> <li>prevent further complications<br></li> <li>prevent blood clots from forming. </li> </ul><h2>Key points</h2> <ul> <li>CNS vasculitis is treated with medicine to suppress the immune system and prevent blood clots. Treatment takes about two years. </li> <li>While your child is being treated for CNS vasculitis, it is important to prevent infection and talk to your doctor about any side effects. </li> <li>You know your child best. Tell your child's doctor about any changes in behaviour or anything that seems unusual or important. </li> </ul><h2>Preventing infection during treatment for CNS vasculitis</h2> <p>The medicines for CNS vasculitis make the immune system less active. This means your child is more likely to get sick if they come in contact with germs. To help keep your child and family healthy: </p> <ul> <li>Wash hands often. </li> <li>Stay away from anyone with an illness that is catching. </li> <li>Keep all family members' immunizations up to date. </li> </ul> <p>Remember, your child's immune system is still working. Your child does not need to "live in a bubble." Your child can still have a normal lifestyle and stay healthy. </p> <p>Do not be afraid to ask your child's doctor if you have any questions.</p> <h3>Immunizations</h3> <p>While your child is being treated for CNS vasculitis, they should not take live vaccines. One common live vaccine is the MMR (measles, mumps and rubella) vaccine. </p> <p>Ask your doctor which immunizations are safe for your child to have.</p><h2>What to expect from treatment</h2> <p>Every child is different, so we cannot say exactly what will happen to your child. The good news is that medicine can treat the blood vessel inflammation and stop it from coming back. But your doctor cannot know ahead of time whether your child's brain will fully recover from any damage. </p> <p>We do know that children's brains have more ability than adults' brains to "rewire" themselves. This means they can sometimes find new pathways to replace a damaged area. </p><h2>Treatment for CNS vasculitis takes about two years</h2> <p>Treatment for CNS vasculitis is a slow process. The entire treatment plan takes at least two years.</p> <p>Not all types of childhood CNS vasculitis are treated the same way. Different children will need different medicines for different amounts of time. If the CNS vasculitis symptoms flare up, the doctors may decide to treat your child for longer. If the treatment works fast, the doctors will give less medicine. </p> <h3>Progressive large vessel CNS vasculitis and small vessel CNS vasculitis</h3> <p>Children with small vessel or progressive large vessel CNS vasculitis are usually treated in two stages:</p> <ul> <li>In the first stage, your child will take high doses of strong medicine. This is called the induction stage. The goal is to rescue the brain by treating the severe inflammation in your child's blood vessels. Your child will start with high doses of prednisone. The doctor will slowly lower the dose over the next nine months. </li> <li>Your child may also take cyclophosphamide. If so, they will take it every month for the first six months. </li> <li>In the second stage, your child will take a gentler combination of medicines for another 18 months. This is called the maintenance stage. The aim during this stage is to help stop CNS vasculitis from coming back while your child's brain is healing. The medicines are usually azathioprine or mycophenolate mofetil, plus low doses of prednisone. </li> </ul> <p>This type of treatment is called an induction-maintenance strategy.</p> <p>At the same time, your child will take a blood thinner to prevent blood clots.</p> <h3>Non-progressive CNS vasculitis</h3> <p>Children with non-progressive CNS vasculitis are usually treated with a high dose of prednisone for three months. Then your child will take smaller and smaller doses of prednisone over the next months. Taking smaller and smaller doses is called tapering.</p> <p>At the same time, your child will take a blood thinner to prevent blood clots.</p><h2>CNS vasculitis is treated with medicine</h2> <p>Your child will need to take different kinds of medicine for CNS vasculitis:</p> <ul> <li>Medicine to suppress the immune system and reduce the inflammation in the blood vessel walls. This includes prednisone, <a href="/Article?contentid=113&language=English">cyclophosphamide</a>, azathioprine and mycophenolate mofetil. </li> <li>Medicine to make the blood thinner and prevent blood clots. This includes low-dose <a href="/Article?contentid=77&language=English">ASA (acetylsalicylic acid)</a> and heparin. </li> </ul> <p>Your child will be taking these medicines for many months. You need to know about them and about the side effects that your child may have. These are described in more detail below. </p> <p>If you are worried about any side effects, talk to your child's doctor.<br></p> <h2>Heparin</h2> <p>Children with large vessel CNS vasculitis often take intravenous (IV) heparin at first. Intravenous means your child will take this medicine through a needle or a tube that puts it directly into their bloodstream. </p> <p>Later, your child may take low molecular weight heparin (LMWH). This medicine is given with a needle under your child's skin.</p> <h2>Acetylsalicylic acid (ASA)</h2> <p>If your child has large vessel CNS vasculitis, they will also take <a href="/Article?contentid=1173&language=English">ASA (acetylsalicylic acid)</a> for the whole time they are being treated. ASA makes your child's blood thinner. This helps your child's blood travel through the blood vessels. </p> <p>Your child will take a very low dose of ASA, between 2 and 5 mg per kilogram of body weight per day. At this dose, ASA has no major side effects. Some children may have an upset stomach. </p> <h2>Prednisone</h2> <p><a href="/Article?contentid=221&language=English">Prednisone</a> is a drug that suppresses the immune system. This means that it lowers the number of immune cells that are attacking your child's blood vessels. When your child takes prednisone for a long time, the immune system is able to "reset" itself and make a new set of healthy immune cells. The new immune cells will not attack your child's body. </p> <p>Your child will be taking a high dose of prednisone to start with. As the treatment goes on, the doctor will lower the dosage.</p> <p>Your child needs to take the amount of prednisone that the doctor prescribes. This is very important. If your child is taking high doses of prednisone and then suddenly stops, your child's body will not be able to adjust to the change. </p> <p>The side effects of prednisone are not pleasant, but there is no other way to treat CNS vasculitis. The effects are stronger at higher doses and with longer courses of treatment. The main side effects are: </p> <ul> <li>weight gain </li> <li>more risk of getting infections </li> <li>hair growth </li> <li>stretch marks </li> <li>acne </li> <li>mood swings </li> <li>upset stomach </li> <li>higher blood pressure </li> <li>higher blood sugar </li> <li>thinning bones (osteoporosis) </li> </ul> <p>These side effects are all temporary. They will go away as soon as your child stops taking the prednisone.</p> <h2>Cyclophosphamide</h2> <p><a href="/Article?contentid=113&language=English">Cyclophosphamide</a> also suppresses the immune system. It slows down or stops the growth of immune system cells. Your child will take cyclophosphamide once a month through an IV tube. </p> <p>Cyclophosphamide is also used to treat some kinds of cancer. But we use much lower doses for CNS vasculitis. This means that CNS vasculitis patients have fewer side effects than cancer patients. </p> <p>For children with CNS vasculitis, cyclophosphamide has three main side effects:</p> <ul> <li>more risk of getting infections </li> <li>more risk of bleeding </li> <li>upset stomach and vomiting (throwing up) </li> </ul> <p>A very large dose of cyclophosphamide can make it hard for girls or boys to have children later on. We will watch your child's treatment to make sure they do not reach this dose.</p> <h2>Azathioprine (Imuran)</h2> <p><a href="/Article?contentid=80&language=English">Azathioprine</a> also suppresses the immune system. It stops immune system cells from dividing.</p> <p>Common side effects include:</p> <ul> <li>stomach upset </li> <li>diarrhea </li> <li>allergic reactions </li> <li>a flu-like illness </li> <li>liver irritation </li> </ul> <p>To watch for problems, your child will need a blood test every month.</p> <p>Some people cannot remove azathioprine from their bodies. Before your child starts taking this medicine, they will need a blood test to find out if they can take it safely. </p> <h2>Mycophenolate mofetil (Cellcept)</h2> <p><a href="/Article?contentid=195&language=English">Mycophenolate mofetil (MMF)</a> also suppresses the immune system. It stops immune system cells from getting overactive.</p> <p>The most common side effect is stomach upset. To prevent this, your child should take the medicine with food.</p> <p>A more serious side effect is when MMF stops the body from making white blood cells, red blood cells and platelets. To watch the levels of these blood cells, your child will need regular blood tests. </p><h2>Your child will be monitored during treatment</h2> <h3>MRIs and angiograms</h3> <p>Your child will have MRI tests often during treatment. Your child may also have angiograms. These tests help doctors see how the blood vessels are healing. This lets them make sure your child is getting the right amount of medicine. </p> <h3>Blood tests</h3> <p>Your child will have regular blood tests to see how the medicine affects her immune system. The goal is to keep your child's immune system low enough to stop it attacking the blood vessels, but not so low that your child is at risk for serious infections. </p> <h3>Tests of thinking and learning</h3> <p>When your child is diagnosed with CNS vasculitis, a psychologist will test her thinking and learning skills. Your child will be tested again every year to see if there are any changes. If necessary, the psychologist will work out a plan so that your child's school can help her learn better. </p> <h3>Your observations</h3> <p>Probably the most important way to monitor CNS vasculitis is through what you notice about your child. Your child will come for regular clinic visits. At these visits, the doctor will ask you and your child about any changes in behaviour that you have noticed at home or at school. </p> <p>Here are some examples of things to watch:</p> <ul><li>mood </li> <li>attention span </li> <li>ability to perform daily tasks at home and at school </li></ul> <p>Remember, you know your child best. If anything seems unusual or important, mention it to your doctor.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/CNS_vasculitis_treatment.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/CNS_vasculitis_treatment.jpgCNS vasculitis: Treatment

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