Takayasu’s Arteritis

Background/Epidemiology

  • Rare, inflammatory vasculitis predominantly affecting the aorta and its major branches (occasionally pulmonary arteries)
    • Characterised by granulomatous inflammation of the vessel wall, leading to vessel occlusion or weakness of the vessel wall
  • Age of onset is usually 25-30; much more common in females (8:1); more common in Eastern Asia

Presentation

  • Around 40-50% patients present with systemic features e.g. fever, fatigue, weight loss, arthralgia/myalgia
  • Around 50-60% of patients present with ischaemia (or consequences of ischaemia) of some sort (occlusive disease)
    • Claudication of the jaw/periphery; hypertension; syncope
    • TIA/Stroke; seizures; dizziness/headaches
    • Angina/MI, heart failure; aortic incompetence; aortic dissection; aortic coarctation
    • Haemoptysis/pleuritis
  • A classical finding is a >10mmHg discrepency between right and left arms.  Other findings include absent/weak radial and peripheral (leg) pulses; arterial bruits; hypertension’

Investigations

  • FBC may show a normocytic, normochromic anaemia
  • Angiography is the main investigation- reveals features of aortic disease

Management

  • High-dose steroids and immunosuppression

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