Learn About Takayasu Arteritis
Takayasu arteritis is an inflammation of large arteries such as the aorta and its major branches. The aorta is the artery that carries blood from the heart to the rest of the body.
Pulseless disease, Large-vessel vasculitis
The cause of Takayasu arteritis is not known. The disease occurs mainly in children and women between the ages of 20 to 40. It is more common in people of East Asian, Indian or Mexican descent. However, it is now being seen more often in other parts of the world. Several genes that increase the chance of having this problem were recently found.
Takayasu arteritis appears to be an autoimmune condition. This means the body's immune system mistakenly attacks healthy tissue in the blood vessel wall. The condition may also involve other organ systems.
This condition has many features that are similar to giant cell arteritis or temporal arteritis in older people.
Symptoms may include:
- Arm weakness or pain with use
- Chest pain
- Dizziness
- Fatigue
- Fever
- Lightheadedness
- Muscle or joint pain
- Skin rash
- Night sweats
- Vision changes
- Weight loss
- Decreased radial pulses (at the wrist)
- Difference in blood pressure between the two arms
- High blood pressure (hypertension)
There may also be signs of inflammation (pericarditis or pleuritis).
Treatment of Takayasu arteritis is difficult. However, people who have the right treatment can improve. It is important to identify the condition early. The disease tends to be chronic, requiring long-term use of anti-inflammatory medicines.
MEDICINES
Most people are first treated with high doses of corticosteroids such as prednisone. As the disease is controlled the dose of prednisone is decreased.
In almost all cases, immunosuppressive medicines are added to reduce the need for long-term use of prednisone and yet maintain control of the disease.
Conventional immunosuppressive medicines such as methotrexate, azathioprine, mycophenolate, cyclophosphamide, or leflunomide are often added.
Biologic medicines may also be effective. These include TNF inhibitors such as infliximab, etanercept, and tocilizumab.
SURGERY
Surgery or angioplasty may be used to open up narrowed arteries to supply blood or open up the constriction.
Aortic valve replacement may be needed in some cases.
Johns Hopkins Bayview Medical Center
Dr. Philip Seo is an Associate Professor in the Division of Rheumatology. A graduate of Harvard College and the College of Physicians and Surgeons at Columbia University, Dr. Seo completed his Internal Medicine training as a member of the Osler Medical Service at the Johns Hopkins Hospital. Since then, he has worked at Johns Hopkins in several capacities, including as a hospitalist at Johns Hopkins Bayview Medical Center, and as an Assistant Chief of Service of the Department of Medicine at the Johns Hopkins Hospital, before joining the Division of Rheumatology. Dr. Seo is the Director of the Johns Hopkins Vasculitis Center and Director of the Johns Hopkins Rheumatology Fellowship Program. His clinical interests lie in the assessment and treatment of patients with systemic vasculitis, in particular, the ANCA-associated vasculitides, which include granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis. Dr. Seo is rated as an Elite provider by MediFind in the treatment of Takayasu Arteritis. His top areas of expertise are Granulomatosis with Polyangiitis, Vasculitis, Microscopic Polyangiitis, Takayasu Arteritis, and Tissue Biopsy.
Perelman Center For Advanced Medicine
Peter Merkel is a Rheumatologist in Philadelphia, Pennsylvania. Dr. Merkel is rated as an Elite provider by MediFind in the treatment of Takayasu Arteritis. His top areas of expertise are Granulomatosis with Polyangiitis, Vasculitis, Microscopic Polyangiitis, Takayasu Arteritis, and Tissue Biopsy. Dr. Merkel is currently accepting new patients.
Tanaz Kermani is a Rheumatologist in Santa Monica, California. Dr. Kermani is rated as an Elite provider by MediFind in the treatment of Takayasu Arteritis. Her top areas of expertise are Giant Cell Arteritis (GCA), Temporal Arteritis, Vasculitis, and Takayasu Arteritis. Dr. Kermani is currently accepting new patients.
This disease can be fatal without treatment. However, a combined treatment approach using medicines and surgery has reduced death rates. Adults have a better chance of survival than children.
Complications may include:
- Blood clot
- Heart attack
- Heart failure
- Pericarditis
- Aortic valve insufficiency
- Pleuritis
- Stroke
- Gastrointestinal bleeding or pain from blockage of bowel blood vessels
Contact your health care provider if you have symptoms of this condition. Immediate care is needed if you have:
- Weak pulse
- Chest pain
- Breathing difficulty
Summary: Systemic vasculitis refers to a group of rare diseases characterized by inflammation of blood vessel walls, which may cause ischemia and structural damage in various organs. Among large-vessel vasculitides, Takayasu arteritis primarily affects the aorta and its main branches, whereas Behçet's disease is a variable vessel vasculitis involving arteries and veins of all sizes. Both conditions can lea...
Background: \- Vasculitis is a group of diseases that inflame and damage blood vessels and tissue. It can cause many medical problems. Few tests can diagnose the disease, and none can reliably predict a relapse. Researchers want to study people s genes and follow people over time to see how the disease affects them.
Published Date: December 31, 2023
Published By: Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Ehlert BA. Takayasu disease. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 140.
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