CV

Takayasu Arteritis

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Takayasu Arteritis

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