Nosebleeds & Vasculitis: Is There a Connection?

Yes, epistaxis can be a manifestation of vasculitis—but most nosebleeds are not vasculitis‑related.

Vasculitides That Commonly Cause Epistaxis

• Granulomatosis with polyangiitis (GPA, formerly Wegener’s) – Sinonasal involvement in >90%.
• Microscopic polyangiitis (MPA)
• Eosinophilic granulomatosis with polyangiitis (EGPA/Churg‑Strauss)
• Behçet’s disease – Mucocutaneous ulcers + vascular inflammation.

When to Suspect Vasculitis

• Recurrent, bilateral, heavy nosebleeds
• Accompanying sinusitis, hearing loss, cough, hemoptysis, rash, renal signs, neuropathy
• Elevated inflammatory markers (CRP, ESR), ANCA positivity

Next Steps

See a rheumatologist or ENT. Workup: ANCA panel, imaging (sinus CT), biopsy if indicated. Early treatment (glucocorticoids ± rituximab/cyclophosphamide) prevents organ damage.