Takayasu's arteritis (patient information)

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Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Xyz?
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
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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:
  • Arteriogram
  • Angiogram
  • Complete blood count (CBC)
  • C-reactive protein (CRP)
  • Electrocardiogram (ECG)
  • Erythrocyte sedimentation rate (ESR)
  • Magnetic resonance angiography (MRA)
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT)
  • Ultrasound
  • X-ray of the chest

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

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm