Vasculitis Damage Index (VDI)

Document any organ damage that has occurred in patients since the onset of vasculitis


1.Significant muscle atrophy or weakness?
2.Deforming/erosive arthritis?
3.Osteoporosis/vertebral collapse?
4.Avascular necrosis?
7.Cutaneous ulcers?
8.Mouth ulcers?
10.Retinal change?
11.Optic atrophy?
12.Visual impairment/diplopia?
13.Blindness in one eye?
14.Blindness in second eye?
15.Orbital wall destruction?
16.Hearing loss?
17.Nasal blockage/chronic discharge/crusting?
18.Nasal bridge collapse/septal perforation?
19.Chronic sinusitis/radiological damage?
20.Subglottic stenosis (no surgery)?
21.Subglottic stenosis (with surgery)?
22.Pulmonary hypertension?
23.Pulmonary fibrosis?
24.Pulmonary infarction?
25.Pleural fibrosis?
26.Chronic asthma?
27.Chronic breathlessness?
28.Impaired lung function?
30.Myocardial infarction?
31.Subsequent myocardial infarction?
33.Valvular disease?
34.Pericarditis ≥ 3 mths or pericardectomy?
35.Diastolic BP ≥ 95 or requiring antihypertensives?
36.Absent pulses in one limb?
37.2nd episode of absent pulses in one limb?
38.Major vessel stenosis (peripheral vascular disease)?
39.Claudication >3 mths
40.Minor tissue loss (due to peripheral vascular disease)?
41.Major tissue loss (due to peripheral vascular disease)?
42.Subsequent major tissue loss (due to peripheral vascular disease)?
43.Complicated venous thrombosis?
44.Gut infarction/resection?
45.Mesenteric insufficiency/pancreatitis?
46.Chronic peritonitis?
47.Oesophageal stricture/surgery?
48.Estimated/measured GFR ≤50%
49.Proteinuria ≥0.5g/24hr?
50.End stage renal disease?
51.Cognitive impairment?
52.Major psychosis?
54.Cerebrovascular accident?
55.2nd cerebrovascular accident?
56.Cranial nerve lesion?
57.Peripheral neuropathy?
58.Transverse myelitis?
59.Gonadal failure?
60.Marrow failure?
62.Chemical cystitis?


The Vasculitis Damage Index (VDI) has been validated and used as a formal assessment tool in ANCA-associated vasculitis clinical trials. It has also been validated for use in a range of systemic vasculitides.

The VDI was developed as a tool to distinguish vasculitis-induced chronic damage from active inflammation or persistent disease.

It requires that disease manifestations be present for at least 3 months before being scored as damage rather than ongoing activity. The cause of damage (ie vasculitis vs treatment) is not taken into consideration.

The VDI includes 64 items that are categorized into 11 groups (by organ system)


Exley AR, Bacon PA, Luqmani RA, Kitas GD, Gordon C, Savage CO, Adu D.

Arthritis and Rheumatism 1997, 40 (2): 371-80

Flossmann O, Bacon P, de Groot K, Jayne D, Rasmussen N, Seo P, Westman K, Luqmani R.

Annals of the Rheumatic Diseases 2007, 66 (3): 283-92

The Vasculitis Damage Index (VDI) calculator is created by QxMD.

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1. Significant muscle atrophy or weakness?

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