Takayasu's arteritis (TA)
What is it?
This is a rare vasculitis that affects the aorta and its branches, especially the arteries of the hands and head. Inflammation of the arterial wall causes a decrease in the lumen of various degrees (stenosis), up to occlusion, and, as a result, a decrease in blood flow.
When the hand area is affected, this phenomenon leads to a loss of peripheral pulse (“no pulse disease”).
The disease was first described in 1908 by ophthalmologist Mikoto Takayasu, but officially was given the name “Takayasu disease” around 1975.
Causes and risk factors
The disease mainly affects women of childbearing age (15-30 years) and is more common in Eastern countries.
The causes of the disease are unknown.
Which are the symptoms?
The symptoms are very diverse depending on the affected vessel: pain along the affected arteries and symptoms of ischemia of the perfused organs (for instance, intermittent claudication, fainting, pain in the heart, abdominal pain).
Systemic symptoms may also be present, such as:
- night sweats;
- joint pain.
Characteristic are some objective signs of vascular occlusion:
- lack of arterial pulse;
- difference in blood pressure between two opposite limbs;
- presence of noises along the course of the arteries.
Complications of the disease are arterial hypertension due to damage to the renal arteries, ischemic retinopathy, and aortic valve insufficiency.
Laboratory tests show increase of ESR, anemia, leukocytosis, and hypergammaglobulinemia.
How is it diagnosed?
The diagnosis is confirmed by angiographic examination of the arteries and, in some cases, by ultrasound color Doppler examination of the vessels.
How is it treated?
Corticosteroids have been found to limit inflammatory activity and slow the progression of the disease.
In some resistant cases, immunosuppressants (cyclophosphamide or methotrexate) may be used.
In patients at risk of organ damage during the remission phases, surgical interventions, such as revascularization (bypass surgery) or percutaneousintraluminal angioplasty (PTA) may also be performed.
The disease is mostly progressive, with a variable course, but spontaneous remissions are possible.
Where do we treat it?
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