Disease: Arteritis, Takayasu's

Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

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 primarily damages the aorta — the large artery that carries blood from your heart to the rest of your body — and the aorta's 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.

The goal of treatment is to relieve inflammation in the arteries and prevent potential complications. Even with early detection and treatment, however, Takayasu's arteritis can be challenging to manage.

Source: http://www.mayoclinic.com

Stage 1 symptoms

Takayasu's arteritis symptoms often occur in two stages. In the first stage, you're likely to feel unwell with:

  • Fatigue
  • Fast and unintentional weight loss
  • Muscle aches
  • Joint pain
  • Slight fever

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

Stage 2 symptoms

Second-stage symptoms begin to develop when inflammation has caused arteries to narrow. At this point, there's less blood, oxygen and nutrients reaching your organs and tissues. These signs and symptoms may include:

  • Arm or leg weakness or pain with use (claudication)
  • Lightheadedness or dizziness
  • Fainting
  • Headaches
  • Memory problems
  • Trouble thinking
  • Shortness of breath
  • Visual problems
  • High blood pressure
  • Difference in blood pressure between your arms
  • A difficult-to-find or absent pulse in the wrists — Takayasu's arteritis is sometimes called pulseless disease because narrowed arteries can make normal pulses difficult or impossible to detect
  • Too few red blood cells (anemia)
  • Chest pain
  • Abdominal pain

When to see a doctor

If you have symptoms that might suggest Takayasu's arteritis, see your doctor. Many signs and symptoms of Takayasu's arteritis are similar to those of other conditions, which can make diagnosis challenging. Still, early detection of the disease is important for getting the most benefit from treatment and preventing complications.

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 disease flare or a complication of treatment.

Source: http://www.mayoclinic.com

In 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. The result is reduced blood flow to vital tissues and organs, which can lead to serious complications and even death. Sometimes arteries become abnormally dilated, leading to aneurysms that may rupture.

Just what causes the initial inflammation in Takayasu's arteritis isn't known. It's likely that Takayasu's arteritis is an autoimmune disease in which your immune system malfunctions and attacks your own arteries as if they were foreign substances. The disease may be triggered by a virus or other infection.

Source: http://www.mayoclinic.com

Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

Takayasu's arteritis can be challenging to detect, and some people go years without an accurate diagnosis. Your doctor may use some of the following steps and tests to help rule out other conditions that closely resemble Takayasu's arteritis and to confirm the diagnosis:

  • Medical history and physical exam. Your doctor will examine you and ask you questions about your general health, including questions about heart and vascular disease.
  • Blood tests. Your doctor may order blood tests to check for signs of inflammation in your body, such as a high white blood cell count or high levels of C-reactive protein, an inflammatory substance produced by your liver. Another blood test commonly used to help identify inflammatory disorders is called the erythrocyte sedimentation rate (sed rate). Your doctor may also check for anemia.
  • Angiography. Traditionally, doctors have used an X-ray test called an angiogram as one of the more definitive tests for diagnosing Takayasu's arteritis. During an angiogram, a thin, flexible tube called a catheter is inserted into a large blood vessel. 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) or blockage of a blood vessel. A person with Takayasu's arteritis generally has several areas of stenosis.
  • Magnetic resonance angiography (MRA). Increasingly, doctors are using this less invasive form of angiography in place of traditional angiography as a test for Takayasu's arteritis. MRA 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.
  • Magnetic resonance imaging (MRI). An MRI is similar to an MRA in that it uses radio waves and a magnetic field to create detailed images of organs in the body and allows your doctor to check for possible damage. MRI doesn't use a contrast medium, however.
  • 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. Doppler ultrasound can also help distinguish between Takayasu's arteritis and atherosclerosis, a much more common condition caused by the buildup of cholesterol particles and other cellular debris in your arteries.

Unlike other types of vasculitis, the removal and analysis of tissue (biopsy) is not usually used to diagnose Takayasu's arteritis.

Because Takayasu's arteritis has a tendency to recur or flare up after being in remission for a while, these tests may be used not only for diagnosis but also for monitoring the progress of the disease and following up on effectiveness of treatment. Some of the medications used for Takayasu's arteritis may have potentially harmful effects over the long run, so it's important for you and your doctor to know when medication is beneficial and when its risks outweigh its benefits.

Source: http://www.mayoclinic.com

The severity of Takayasu's arteritis may vary. In some people, the condition remains mild and doesn't produce complications. But in others, extended or recurring cycles of inflammation and healing in the arteries can lead to one or more of the following:

  • 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), the heart valves (valvulitis) or the sac around the heart (pericarditis)
  • 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
  • Ischemic stroke, a type of stroke that occurs as a result of reduced or blocked blood flow in arteries leading to your brain
  • Transient ischemic attack, a temporary stroke that has all the symptoms of an ischemic stroke without causing lasting 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, an uncommon event that may occur as a result of reduced blood flow to the heart
  • Lung involvement when the arteries to the lungs (pulmonary arteries) become diseased

Pregnancy

A healthy pregnancy is possible for women with Takayasu's arteritis. However, the disease can affect your fertility and pregnancy. If you have Takayasu's arteritis and are planning on becoming pregnant, it's important to work with your doctor to develop a comprehensive plan to limit complications of pregnancy before you conceive. In addition, you'll be closely monitored throughout your pregnancy.

Source: http://www.mayoclinic.com

When Takayasu's arteritis is identified and treated early, the prognosis is usually good. One of your greatest challenges 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 any medications you take and report any changes in your health to your doctor.
  • Eat a healthy diet. Eating well can help prevent potential problems that may 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.

    Be sure to get adequate amounts of calcium and vitamin D to help prevent osteoporosis, a primary side effect of treatment with corticosteroids. Ask your doctor what the proper amount of these nutrients is for you. If you find it hard to get calcium from your diet because you don't eat dairy products, for example, talk with your doctor about trying calcium supplements, which are often combined with vitamin D and may help combat thinning bones.

  • 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.

Eat a healthy diet. Eating well can help prevent potential problems that may 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.

Be sure to get adequate amounts of calcium and vitamin D to help prevent osteoporosis, a primary side effect of treatment with corticosteroids. Ask your doctor what the proper amount of these nutrients is for you. If you find it hard to get calcium from your diet because you don't eat dairy products, for example, talk with your doctor about trying calcium supplements, which are often combined with vitamin D and may help combat thinning bones.

Source: http://www.mayoclinic.com

Takayasu's arteritis primarily affects young girls and women in their 20s and 30s. The disorder occurs worldwide, but it's most common in Asian women.

Source: http://www.mayoclinic.com

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