Definition

What is Takayasu’s arteritis?

Takayasu’s arteritis is a type of vasculitis, a group of disorders that cause blood vessel inflammation. In Takayasu’s arteritis, the inflammation damages the aorta — the large artery that carries blood from your heart to the rest of your body — and its main branches.

The disease can lead to blockages or narrowed arteries (stenosis) or abnormally dilated arteries (aneurysms). Takayasu’s arteritis can also lead to arm or chest pain and high blood pressure and eventually to heart failure or stroke.

If you don’t have symptoms, you may not need treatment. Or you may need medications to control the inflammation in the arteries and prevent complications. But even with treatment, relapses are common.

How common is Takayasu’s arteritis?

Takayasu’s arteritis is an uncommon condition. Takayasu’s arteritis is much more common in women than men. The disease most often starts in young adults, but children and middle-aged people may get it, too. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Takayasu’s arteritis?

Approximately half of all people with Takayasu’s arteritis will have a sense of generalized illness. This may include low grade fevers, swollen glands, anemia, dizziness, night sweats, muscle aches, and/or arthritis.

The changes that occur in Takayasu’s arteritis are often gradual, allowing alternate (collateral) routes of blood flow to develop. These alternate routes are typically smaller blood vessels. The collateral vessels may not be able to carry as much blood as the normal vessels.

In general, however, the blood flow that occurs beyond an area of narrowing is almost always adequate to allow tissues to survive. In rare cases, if collateral blood vessels are not available in sufficient quantity, the tissue that is normally supplied with blood and oxygen by those vessels will die.

Narrowing of blood vessels to the arms or legs may cause fatigue, pain, or aching due to reduced blood supply — especially during activities such as shampooing the hair, exercising, or walking. It is much less common for decreased blood flow to cause a stroke or a heart attack. In some people, decreased blood flow to the intestines may lead to abdominal pain, especially after meals.

Decreased blood flow to the kidneys may cause high blood pressure, but rarely causes kidney failure.

Some people with Takayasu’s arteritis may not have any symptoms. Their diagnosis may be discovered when their doctor attempts to take their blood pressure and has trouble getting a reading in one or both arms. Similarly, a doctor may notice that the strength of pulses in the wrists, neck, or groin may not be equal, or the pulse on one side may be absent.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Takayasu’s arteritis?

The exact cause of Takayasu’s arteritis is unknown.

Risk factors

What increases my risk for Takayasu’s arteritis?

Takayasu’s arteritis primarily affects girls and women between the ages of 10 and 40. The disorder occurs worldwide, but it’s most common in Asia. Sometimes the condition runs in families.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Takayasu’s arteritis diagnosed?

Your doctor will ask you about your signs and symptoms, conduct a physical exam, and take your medical history. He or she may also have you undergo some of the following tests and procedures to help rule out other conditions that resemble Takayasu’s arteritis and to confirm the diagnosis. Some of these tests may also be used to check on your progress during treatment.

  • Blood tests. These tests can be used to look for signs of inflammation, such as a high level of C-reactive protein or a high erythrocyte sedimentation rate — commonly referred to as a sed rate. Your doctor may also check for anemia.
  • X-rays of your blood vessels (angiography). During an angiogram, a flexible catheter is inserted into a large artery or vein. A special dye (contrast medium) is then injected into the catheter, and X-rays are taken as the dye fills your arteries or veins. The resulting images allow your doctor to see if blood is flowing normally or if it’s being slowed or interrupted due to narrowing (stenosis) of a blood vessel. A person with Takayasu’s arteritis generally has several areas of stenosis.
  • Magnetic resonance angiography (MRA). This less invasive form of angiography produces detailed images of your blood vessels without the use of catheters or X-rays, although an intravenous contrast medium generally is used. MRA works by using radio waves in a strong magnetic field to produce data that a computer turns into detailed images of tissue slices.
  • Computerized tomography (CT) angiography. This is another noninvasive form of angiography combining computerized analysis of X-ray images with the use of intravenous contrast dye to allow your doctor to check the structure of your aorta and its nearby branches and to monitor blood flow.
  • Doppler ultrasound, a more sophisticated version of the common ultrasound, has the ability to produce very high-resolution images of the walls of certain arteries, such as those in the neck (carotid arteries) and those in the shoulder (subclavian arteries). It may be able to detect subtle changes in these arteries before other imaging techniques can.
  • Positron emission tomography (PET). This imaging is able to measure the intensity of inflammation in blood vessels. Before the scan, you are given a radioactive drug (tracer).

Unlike other types of vasculitis, Takayasu’s arteritis is not usually diagnosed by the removal and analysis of tissue (biopsy).

How is Takayasu’s arteritis treated?

Corticosteroids — often called simply “steroids” — are the most common treatment for Takayasu’s arteritis. Steroids work within hours after the first dose is given. While this drug often is dramatically effective, it may be only partially effective for some people.

Once it is apparent that the disease is under control, doctors slowly reduce the dosage of prednisone (a steroid) to sustain improvement, thereby trying to minimize treatment side effects. In some people, it is possible to gradually discontinue medication without a relapse.

As the dosage of prednisone is gradually reduced, about half of all patients will have recurrent symptoms or progression of illness. This has led researchers to explore additional treatments to produce remission. Among medications that have been tried, with varying degrees of success, are immunosuppressive drugs such as methotrexate.

When these drugs are added to prednisone to treat Takayasu’s arteritis, 50% of patients who had previously relapsed will achieve remission and be able to gradually discontinue prednisone. Overall, about 25% of patients will have disease that is not entirely controlled without continued use of these treatments. This emphasizes the need for continuing research to identify better and less toxic treatments for Takayasu’s arteritis and other forms of vasculitis.

Many patients with Takayasu’s arteritis have high blood pressure. Careful control of blood pressure is very important. Inadequate treatment of high blood pressure may result in stroke, heart disease, or kidney failure. In some cases, it is desirable to stretch narrow vessel openings with a balloon (a technique known as “angioplasty”) or to do a bypass operation to restore normal flow to the kidney. This may result in normal blood pressure without the need to use blood pressure drugs.

Some patients may have serious disabilities because of narrowed blood vessels that supply other sites, such as the arms or legs. Bypass operations may correct these abnormalities. Aneurysms also can be surgically repaired.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Takayasu’s arteritis?

The following lifestyles and home remedies might help you cope with Takayasu’s arteritis:

  • Understand your condition. Learn everything you can about Takayasu’s arteritis and its treatment. Know the possible side effects of the drugs you take, and tell your doctor about any changes in your health. Ask your doctor about the benefit of taking low-dose aspirin regularly.
  • Eat a healthy diet. Eating well can help prevent potential problems that can result from your condition and medications, such as high blood pressure, thinning bones and diabetes. Emphasize fresh fruits and vegetables, whole grains, and lean meats and fish, while limiting salt, sugar and alcohol.If you’re taking a corticosteroid drug, ask your doctor if you need to take a vitamin D or calcium supplement.
  • Exercise regularly. Regular aerobic exercise, such as walking, can help prevent bone loss, high blood pressure and diabetes. It also benefits your heart and lungs. In addition, many people find that exercise improves their mood and overall sense of well-being.
  • Avoid all tobacco products. It’s important to stop using all forms of tobacco to reduce the risk of injuring your blood vessels and tissues even more.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: December 15, 2017 | Last Modified: December 15, 2017

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