An extract of Ashton Kutcher saying he was “lucky to be alivemade headlines on Monday after the actor revealed he was battling an autoimmune disease that caused him to temporarily lose his ability to see, hear and walk. Without going into specifics, Kutcher shared that it took him “about a year” to “rebuild everything” after his vasculitis diagnosis. “You don’t really appreciate him until he’s gone,” the actor said.
An expert tells rolling stone that Kutcher’s symptoms match what would likely be an “extremely severe” case of the autoimmune disease. It also explains why a drug used to treat affected patients may be difficult to access in abortion-banning states, following the reversal of Roe vs. Wade.
“Vasculitis itself is quite common. It’s a short-term thing for most people and it happens spontaneously,” says Dr. John Oghalai, chair of the department of otolaryngology at USC Keck School of Medicine. “What he got seems extremely serious.”
Vasculitis is an inflammatory disease in which the immune system fights blood vessels in the body, Oghalai explains in simple terms. “It means your blood vessels are under attack,” says Oghalai. “And it happens for no clear reason.”
Some versions of the disease focus on large vessels like the aorta, while others may focus on small vessels in the ear or brain. (Vasculitis in the brain can even lead to seizures or strokes, he says.) Given that Kutcher apparently made a full recovery, that likely means he faced only partial loss. blood flow to his eyes and ears. In more severe cases, “you may have permanent hearing loss and imbalance,” adds Oghalai. “I see a lot of patients with autoimmune diseases like vasculitis that cause [complete] hearing loss… It’s very dangerous.
Oghalai says full recovery from vasculitis is “fairly common”, but the next step is to find out what caused Kutcher’s disease to prevent it from happening again, as it “usually comes back”, says Oghalai .
“Common ways to diagnose a patient with vasculitis are blackheads on the tips of your fingers or toes, as these are furthest from your heart,” says Oghalai. “As the vessels become inflamed, blood cannot flow through them, which can lead to cell death at the very distal ends.”
Oghalai says patients with vasculitis are usually first given a steroid, such as prednisone, which suppresses the immune system. If the steroid doesn’t seem to fix the problem or if the vasculitis comes back, patients can be given methotrexate, “an immunosuppressive drug used for vasculitis and other types of autoimmune diseases,” says Oghalai. “But it is also used to terminate a pregnancy.”
Access to methotrexate, a common and life-saving medication used to treat Kutcher’s diagnosis, may become more difficult to obtain for people with chronic conditions in a post-hospitalization setting.Roe vs. Wade world.
In a state like California, or with a cisgender man like Kutcher, access to drugs is probably easy. But in states that ban abortion, people with chronic conditions may struggle to fill their prescriptions. “It’s interesting to see how the politics of what’s happening today can really impact people’s ability to get the care they need. Even if it’s a totally unrelated thing,” says Oghalai. “And to me, that’s a shame.”
A recent article by Washington Post explored how some women struggle to access drugs like methotrexate in red states, like Tennessee. A Nashville pharmacist described the now difficult access to the drug – used by almost 60% of rheumatoid arthritis patients, according to the Johns Hopkins Arthritis Center – as the “tip of the iceberg”.
“They may not be able to get it,” Oghalai says. “They should find a pharmacist willing to give them this drug, knowing that it could be used for something illegal in their state.”
The American College of Rheumatology has assembled a task force to assess the problem and how it has and may affect chronic disease patients nationwide. The chairman of the group told the Job, “There is concern … that one of the unintended consequences is that patients will have reduced access to this drug and other drugs.”