Takayasu’s Aortitis and Arteritis
Jameel Tariq Galloway Ashley Davidoff MD
Takayasu’s arteritis is an inflammatory disease of the aorta and its first order branches
It is caused by intimal proliferation and fibrosis along with fibrous scarring and degeneration of the elastic fibers of the media of the aorta and large arteries. The M:F is 1:8. Typical age of onset is in teenage years.
As a result of the inflammatory process, the adventitia becomes thickened and the vaso vasorum are destroyed Localized aneurysm formation, post-stenotic dilatation and calcification in the arterial walls are late complications. The process most often involves the arch and its major branches
The clinical diagnosis is suspected when a teenage patient presents with loss of pulses or ischemic parestesias. Non specific findings include fever, malaise, night sweats, arthralgias, fatigue and occasionally pain and tenderness over the affected arteries. Imaging is bes accomplished with CTA or MRA and for the smaller vessels angiography is still a useful modality.
Treatment options include glucocorticoids may relieve systemic symptoms and surgical treatments may be needed for late complications Morbidity and mortality depend on the presence or absence of severe complications such as retinopathy, aortic regurgitation, secondary hypertension or aortic aneurysms There is 97% survival over 7 years in uncomplicated disease and 59% in patients with complications
|20354b01 14 year old male artery thoracic aorta fx smooth narrowing of isthmus of aorta Takayasu’s aortitis angiography angiogram Courtesy Ashley Davidoff MD|
|Davidoff photography copyright 2012 all rights reserved|
“Takayasu Arteritis.” Medline Plus. National Library of Medicine, n.d. Web. 14 June 2012. <http://www.nlm.nih.gov/medlineplus/ency/article/001250.htm>.