Takayasu arteritis (aortic arch syndrome)

Takayasu arteritis (aortic arch syndrome):point_down::point_down::white_check_mark::point_down::white_check_mark:


Definition: granulomatous inflammation of the aorta and its major branches, resulting in stenosis of involved blood vessels and subsequent vascular symptoms Epidemiology


Peak incidence: 15–45 years of age Asian heritage male to female ratio (3:1) Clinical features


Fever, malaise, arthralgia Vascular symptoms Decreased bilateral brachial and radial pulses β†’ β€œpulseless disease” Syncope, angina pectoris Impaired vision Movement-induced muscular pain in one or more limbs Raynaud phenomenon Bilateral carotid bruits Hypertension Skin manifestations Erythema nodosum Urticaria Diagnostics


Laboratory findings: ↑ ESR Angiography (gold standard): detects vascular stenosis Biopsy of affected vessel: granulomatous thickening of aortic arch; plasma cells and lymphocytes in media and adventitia; vascular fibrosis Treatment


Corticosteroids; if necessary, MTX or cyclophosphamide may be administered Surgical intervention (e.g., bypass) may be required if critical stenosis of the aortic arch or its branches occurs. Antihypertensive treatment