Takayasu's arteritis (patient information): Difference between revisions
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==Overview== | ==Overview== | ||
In Takayasu's arteritis [[Symptom|symptoms]] may include arm [[Muscle weakness|weakness]] or pain with use, [[Chest pain]], [[Dizziness]], [[Fever]], [[Arthralgia|joint]] or [[Myalgia|muscle pain]], vision changes, [[Hypertension|high blood pressure (hypertension)]]. Takayasu arteritis appears to be an [[Autoimmunity|autoimmune]] condition. This means the body's [[immune system]] mistakenly attacks healthy tissue. The disease occurs mainly in children and women between the ages of 20 to 40. It is more common in people of East Asian, Indian or Mexican descent. The diagnosis is made when a person has [[Symptom|symptoms]] and [[imaging]] showing [[blood vessel]] narrowing suggesting [[inflammation]]. Possible tests include [[Angiogram]], [[Complete blood count|Complete blood count (CBC)]], [[Electrocardiogram|electrocardiogram (ECG)]], [[Magnetic resonance angiography|magnetic resonance angiography (MRA)]], [[Magnetic resonance imaging|magnetic resonance imaging (MRI)]]. Most people are first treated with high doses of [[Steroid|steroids]]. [[Immunosuppressive drug|Immunosuppressive drugs]], such as [[azathioprine]], [[mycophenolate]], [[methotrexate]], or [[leflunomide]] are often added. Biologic agents including [[TNF inhibitor|TNF inhibitors]] such as [[infliximab]] are recommended for people who do not improve with the previous treatment. [[Surgery]] or [[angioplasty]] may be used to open up narrowed [[Artery|arteries]] to supply [[blood]] or open up the constriction. [[Complication (medicine)|Complications]] may include [[Thrombus|blood clot]], [[Heart attack (patient information)|heart attack]], [[Congestive heart failure (patient information)|heart failure]], [[Pericarditis (patient information)|pericarditis]], [[Stroke (patient information)|stroke]], [[Gastrointestinal bleeding]] or pain from blockage of bowel [[Blood vessel|blood vessels]]. | |||
==What are the Symptoms of Takayasu's arteritis?== | ==What are the Symptoms of Takayasu's arteritis?== | ||
Symptoms may include: | [[Symptom|Symptoms]] may include: | ||
* Arm weakness or pain with use | * Arm [[Muscle weakness|weakness]] or pain with use | ||
* Chest pain | * [[Chest pain]] | ||
* Dizziness | * [[Dizziness]]/ lightheadedness | ||
* Fatigue | * [[Fatigue]] | ||
* Fever | * [[Fever]] | ||
* | * [[Arthralgia|Joint]] or [[Myalgia|muscle pain]] | ||
* Skin [[rash]] | |||
* Skin rash | |||
* Night sweats | * Night sweats | ||
* Vision changes | * Vision changes | ||
* Weight loss | * [[Weight loss]] | ||
* Decreased radial pulses (at the wrist) | * Decreased [[Radial artery|radial]] pulses (at the wrist) | ||
* Difference in blood pressure between the two arms | * Difference in [[blood pressure]] between the two arms | ||
* High blood pressure (hypertension) | * [[Hypertension|High blood pressure (hypertension)]] | ||
==What Causes Takayasu's arteritis?== | ==What Causes Takayasu's arteritis?== | ||
* The cause of Takayasu arteritis is unknown. The disease occurs mainly in children and women between the ages of 20 to 40. It is more common in people of East Asian, Indian or Mexican descent. However, it is now being seen more often in other parts of the world. Several [[Gene|genes]] that increase the chance of having this problem were recently found. | |||
* Takayasu arteritis appears to be an [[Autoimmunity|autoimmune]] condition. This means the body's [[immune system]] mistakenly attacks healthy tissue. The condition may also involve other organ systems. Takayasu arteritis has many features that are similar to [[Temporal arteritis|giant cell arteritis (temporal arteritis)]] in older people. | |||
== Diagnosis == | == Diagnosis == | ||
* There is no [[blood test]] available to make a definite diagnosis. | |||
* The diagnosis is made when a person has [[Symptom|symptoms]] and [[imaging]] showing [[blood vessel]] narrowing suggesting [[inflammation]]. | |||
* Possible tests include: | |||
** Arteriogram | |||
** [[Angiogram]] | |||
** [[Complete blood count|Complete blood count (CBC)]] | |||
** [[C-reactive protein|C-reactive protein (CRP)]] | |||
** [[Electrocardiogram|Electrocardiogram (ECG)]] | |||
** [[Erythrocyte sedimentation rate|Erythrocyte sedimentation rate (ESR)]] | |||
** [[Magnetic resonance angiography|Magnetic resonance angiography (MRA)]] | |||
** [[Magnetic resonance imaging|Magnetic resonance imaging (MRI)]] | |||
** [[Computed tomography|Computed tomography (CT)]] | |||
** [[Ultrasound]] | |||
** [[Chest X-ray|X-ray of the chest]] | |||
==When to Seek Urgent Medical Care?== | ==When to Seek Urgent Medical Care?== | ||
Call your health care provider if you have [[Symptom|symptoms]] of this condition. Weak [[pulse]], [[chest pain]], and [[breathing]] difficulty require immediate care. | |||
==Treatment Options== | ==Treatment Options== | ||
| Line 36: | Line 51: | ||
=== MEDICINES === | === MEDICINES === | ||
* Most people are first treated with high doses of steroids. Immunosuppressive drugs, such as azathioprine, mycophenolate, methotrexate, or leflunomide are often added. | * Most people are first treated with high doses of [[Steroid|steroids]]. [[Immunosuppressive drug|Immunosuppressive drugs]], such as [[azathioprine]], [[mycophenolate]], [[methotrexate]], or [[leflunomide]] are often added. | ||
* Biologic agents including TNF inhibitors such as infliximab are recommended for people who do not improve with the previous treatment. | * Biologic agents including [[TNF inhibitor|TNF inhibitors]] such as [[infliximab]] are recommended for people who do not improve with the previous treatment. | ||
* Other biologic agents that show promising benefits for treating Takayasu's arteritis include tocilizumab, and rituximab. | * Other biologic agents that show promising benefits for treating Takayasu's arteritis include [[tocilizumab]], and [[rituximab]]. | ||
=== SURGERY === | === SURGERY === | ||
* Surgery or angioplasty may be used to open up narrowed | * [[Surgery]] or [[angioplasty]] may be used to open up narrowed [[Artery|arteries]] to supply [[blood]] or open up the constriction. | ||
* Aortic valve replacement may be needed in some cases. | * Aortic valve replacement may be needed in some cases. | ||
| Line 48: | Line 63: | ||
==Prevention== | ==Prevention== | ||
There are no established measures for the [[Prevention (medical)|prevention]] of Takayasu's arteritis. | |||
==What to Expect (Outlook/Prognosis)?== | ==What to Expect (Outlook/Prognosis)?== | ||
This disease can be fatal without treatment. However, a combined treatment approach using medicines and surgery has lowered death rates. Adults have a better chance of survival than children. | This disease can be fatal without treatment. However, a combined treatment approach using medicines and [[surgery]] has lowered [[Mortality rate|death rates]]. Adults have a better chance of [[Survival analysis|survival]] than children. | ||
==Possible Complications== | ==Possible Complications== | ||
[[Complication (medicine)|Complications]] may include: | |||
* [[Thrombus|Blood clot]] | |||
* [[Heart attack (patient information)|Heart attack]] | |||
* [[Congestive heart failure (patient information)|Heart failure]] | |||
* [[Pericarditis (patient information)|Pericarditis]] | |||
* [[Aortic regurgitation|Aortic valve insufficiency]] | |||
* [[Pleurisy|Pleuritis]] | |||
* [[Stroke (patient information)|Stroke]] | |||
* [[Gastrointestinal bleeding]] or pain from blockage of bowel [[Blood vessel|blood vessels]] | |||
==Sources== | ==Sources== | ||
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http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm | http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm | ||
[[Category:Medicine]] | |||
[[Category:Rheumatology]] | |||
[[Category:Up-To-Date]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 18:02, 27 April 2018
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For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2]
Overview
In Takayasu's arteritis symptoms may include arm weakness or pain with use, Chest pain, Dizziness, Fever, joint or muscle pain, vision changes, high blood pressure (hypertension). Takayasu arteritis appears to be an autoimmune condition. This means the body's immune system mistakenly attacks healthy tissue. The disease occurs mainly in children and women between the ages of 20 to 40. It is more common in people of East Asian, Indian or Mexican descent. The diagnosis is made when a person has symptoms and imaging showing blood vessel narrowing suggesting inflammation. Possible tests include Angiogram, Complete blood count (CBC), electrocardiogram (ECG), magnetic resonance angiography (MRA), magnetic resonance imaging (MRI). Most people are first treated with high doses of steroids. Immunosuppressive drugs, such as azathioprine, mycophenolate, methotrexate, or leflunomide are often added. Biologic agents including TNF inhibitors such as infliximab are recommended for people who do not improve with the previous treatment. Surgery or angioplasty may be used to open up narrowed arteries to supply blood or open up the constriction. Complications may include blood clot, heart attack, heart failure, pericarditis, stroke, Gastrointestinal bleeding or pain from blockage of bowel blood vessels.
What are the Symptoms of Takayasu's arteritis?
Symptoms may include:
- Arm weakness or pain with use
- Chest pain
- Dizziness/ lightheadedness
- Fatigue
- Fever
- Joint or muscle pain
- Skin rash
- Night sweats
- Vision changes
- Weight loss
- Decreased radial pulses (at the wrist)
- Difference in blood pressure between the two arms
- High blood pressure (hypertension)
What Causes Takayasu's arteritis?
- The cause of Takayasu arteritis is unknown. The disease occurs mainly in children and women between the ages of 20 to 40. It is more common in people of East Asian, Indian or Mexican descent. However, it is now being seen more often in other parts of the world. Several genes that increase the chance of having this problem were recently found.
- Takayasu arteritis appears to be an autoimmune condition. This means the body's immune system mistakenly attacks healthy tissue. The condition may also involve other organ systems. Takayasu arteritis has many features that are similar to giant cell arteritis (temporal arteritis) in older people.
Diagnosis
- There is no blood test available to make a definite diagnosis.
- The diagnosis is made when a person has symptoms and imaging showing blood vessel narrowing suggesting inflammation.
- Possible tests include:
When to Seek Urgent Medical Care?
Call your health care provider if you have symptoms of this condition. Weak pulse, chest pain, and breathing difficulty require immediate care.
Treatment Options
Treatment of Takayasu arteritis is difficult. However, people who have the right treatment can see improvement. It is important to identify the condition early.
MEDICINES
- Most people are first treated with high doses of steroids. Immunosuppressive drugs, such as azathioprine, mycophenolate, methotrexate, or leflunomide are often added.
- Biologic agents including TNF inhibitors such as infliximab are recommended for people who do not improve with the previous treatment.
- Other biologic agents that show promising benefits for treating Takayasu's arteritis include tocilizumab, and rituximab.
SURGERY
- Surgery or angioplasty may be used to open up narrowed arteries to supply blood or open up the constriction.
- Aortic valve replacement may be needed in some cases.
Where to find Medical Care for Takayasu's arteritis?
Medical care for Takayasu's arteritis can be found here.
Prevention
There are no established measures for the prevention of Takayasu's arteritis.
What to Expect (Outlook/Prognosis)?
This disease can be fatal without treatment. However, a combined treatment approach using medicines and surgery has lowered death rates. Adults have a better chance of survival than children.
Possible Complications
Complications may include:
- Blood clot
- Heart attack
- Heart failure
- Pericarditis
- Aortic valve insufficiency
- Pleuritis
- Stroke
- Gastrointestinal bleeding or pain from blockage of bowel blood vessels