II. Epidemiology
- Age: 30-40 years old
- Gender: Women account for up to 90% of cases
- Race: More common in asian descent
III. Pathophysiology
- Large vessel Vasculitis
- Granulomatous inflammation of the aorta and its branches
IV. Symptoms
- Early in course
- Fatigue
- Weight loss
- Low-grade fever
- Later in course
- Finger coldness and numbness
- Arthralgias
- Myalgias
- Focal symptoms
- Related to specific arterial involvement
- Example: Carotid Artery involvement with CNS symptoms
V. Signs
- Hypotension
- Upper extremities with diminished Arterial Pulses
- Visual disturbances
- Neurologic deficit
VI. Labs
-
Complete Blood Count (CBC)
- Normochromic Normocytic Anemia
- Increased acute phase reactants
- Increased C-Reactive Protein (C-RP)
- Increased Erythrocyte Sedimentation Rate (ESR)
- Pentraxin-3
VII. Imaging: CT angiogram, MRA Angiogram or Standard Angiography of arterial tree
- Smoothly tapering vessel lumens or Occlusion
- Vessel wall thickening
VIII. Differential Diagnosis
- See Vasculitis
- Fibromuscular dysplasia
- Ergotamine toxicity
- Ehlers-Danlos Syndrome
- Temporal Arteritis
IX. Management
- High dose Corticosteroids (e.g. Prednisone 40-60 mg orally daily)
- Monitoring for response with acute phase reactants and imaging
X. References
- Hunder (2011) in UpToDate, Clinical features and diagnosis of Takayasu Arteritis, Accessed 11/30/11