Disease: Takayasu's arteritis

Overview

Takayasu's arteritis (tah-kah-YAH-sooz ahr-tuh-RIE-tis) is a rare 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.

Source: http://www.mayoclinic.com

Symptoms

The signs and symptoms of Takayasu's arteritis often occur in two stages.

Stage 1

In the first stage, you're likely to feel unwell with:

  • Fatigue
  • Unintended weight loss
  • General aches and pains
  • Mild fever

Not everyone has these early signs and symptoms. It's possible for inflammation to damage arteries for years before you realize something is wrong.

Stage 2

During the second stage, inflammation is causing arteries to narrow so less blood, oxygen and nutrients reach your organs and tissues. Stage 2 signs and symptoms may include:

  • Weakness or pain in your limbs with use
  • Lightheadedness, dizziness or fainting
  • Headaches
  • Memory problems
  • Trouble thinking
  • Shortness of breath
  • Visual changes
  • High blood pressure
  • Difference in blood pressure between your arms
  • Decreased pulse
  • Too few red blood cells (anemia)
  • Chest pain
  • Noises heard over the arteries (bruits) when listening with a stethoscope

When to see a doctor

Seek immediate medical attention for shortness of breath, chest pain or signs of a stroke.

Make an appointment with your doctor if you have other signs or symptoms that worry you. Early detection of Takayasu's arteritis is key to getting effective treatment.

If you've already been diagnosed with Takayasu's arteritis, keep in mind that the symptoms of a disease flare (recurrence) are often similar to those that occurred originally. Also pay attention to any new signs or symptoms. These may indicate either a recurrence or a complication of treatment.

Source: http://www.mayoclinic.com

Causes

With Takayasu's arteritis, the aorta and other major arteries, including those leading to your head and kidneys, become inflamed. Over time the inflammation causes changes in these arteries, including thickening, narrowing and scarring.

No one knows exactly what causes the initial inflammation in Takayasu's arteritis. It's likely that the condition is an autoimmune disease in which your immune system attacks your own arteries by mistake. The disease may be triggered by a virus or other infection.

Source: http://www.mayoclinic.com

Diagnosis

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.
  • Ultrasonography. 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).

Source: http://www.mayoclinic.com

Complications

With Takayasu's arteritis, extended or recurring cycles of inflammation and healing in the arteries might lead to one or more of the following complications:

  • Hardening and narrowing of blood vessels, which can cause reduced blood flow to organs and tissues
  • High blood pressure, usually as a result of decreased blood flow to your kidneys
  • Inflammation of the heart, which may affect the heart muscle (myocarditis) or the heart valves
  • Heart failure due to high blood pressure, myocarditis or aortic regurgitation — a condition in which a faulty aortic valve allows blood to leak back into your heart — or a combination of these
  • Stroke, which occurs as a result of reduced or blocked blood flow in arteries leading to your brain
  • Transient ischemic attack (TIA), is like a stroke, producing similar symptoms but causing no permanent damage
  • Aneurysm in the aorta, which occurs when the walls of the blood vessel weaken and stretch out, forming a bulge that has the potential to rupture
  • Heart attack, which may occur as a result of reduced blood flow to the heart

Pregnancy

A healthy pregnancy is possible for women with Takayasu's arteritis. But the disease and drugs used to treat it can affect your fertility and pregnancy. If you have Takayasu's arteritis and are planning on becoming pregnant, work with your doctor to develop a plan to limit complications of pregnancy before you conceive. And during your pregnancy see your doctor regularly for checkups.

Source: http://www.mayoclinic.com

Coping and support

One of the greatest challenges of living with Takayasu's arteritis may be coping with side effects of your medication. The following suggestions may help:

  • 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.

Source: http://www.mayoclinic.com

Risk factors

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.

Source: http://www.mayoclinic.com

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