Summary about Disease
Takayasu arteritis is a rare, chronic, progressive inflammatory disease affecting the aorta and its major branches. This inflammation causes narrowing (stenosis), widening (aneurysm), or blockages in these arteries, leading to reduced blood flow to tissues and organs. It is a form of large vessel vasculitis.
Symptoms
Symptoms vary depending on which arteries are affected and the extent of inflammation. Initial symptoms may be general, while later symptoms are more specific to vascular involvement. Common symptoms include:
General (Early Stage): Fever, fatigue, weight loss, muscle aches, joint pain.
Vascular (Later Stage):
Pain or tenderness over arteries (especially carotid)
Absent or weakened pulses in arms or legs
Difference in blood pressure between arms
Dizziness, lightheadedness, or fainting
Headaches
Visual disturbances (blurred vision, double vision)
Chest pain
Shortness of breath
Pain in the limbs with activity (claudication)
High blood pressure
Skin nodules (rare)
Causes
The exact cause of Takayasu arteritis is unknown. It is believed to be an autoimmune disorder, where the body's immune system mistakenly attacks its own arteries. Genetic factors, infections, and environmental triggers may play a role, but no specific cause has been definitively identified.
Medicine Used
The primary goals of treatment are to reduce inflammation and prevent further artery damage. Medications used include:
Corticosteroids: Such as prednisone, are usually the first-line treatment to reduce inflammation quickly.
Immunosuppressants: Such as methotrexate, azathioprine, mycophenolate mofetil, or cyclophosphamide, are used to suppress the immune system and maintain remission, often in combination with or after corticosteroids.
Biologic Agents: Such as TNF inhibitors (e.g., infliximab, adalimumab) or IL-6 inhibitors (e.g., tocilizumab), may be used if other treatments are ineffective.
Antiplatelet Agents/Anticoagulants: Such as aspirin or warfarin, may be used to prevent blood clot formation, especially if there are areas of artery narrowing or aneurysm.
Antihypertensives: Medications to control high blood pressure, if present.
Is Communicable
No, Takayasu arteritis is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
There are no specific precautions to prevent Takayasu arteritis, as the cause is unknown. However, individuals diagnosed with the condition should:
Adhere strictly to their prescribed medication regimen.
Attend all scheduled follow-up appointments with their healthcare provider.
Manage risk factors for cardiovascular disease, such as high blood pressure, high cholesterol, and smoking.
Report any new or worsening symptoms to their doctor promptly.
Consider genetic counseling if planning to have children.
How long does an outbreak last?
Takayasu arteritis is a chronic disease, and there is no single "outbreak" duration. The active inflammatory phase can last for months or years, and periods of remission (when symptoms are reduced or absent) can be interspersed with periods of relapse (when symptoms worsen). The disease course is highly variable from person to person. Without treatment, the disease can cause progressive damage over many years.
How is it diagnosed?
Diagnosis can be challenging due to the rarity and nonspecific nature of early symptoms. It typically involves a combination of:
Physical Examination: Checking pulses, blood pressure differences, and listening for bruits (abnormal sounds) over arteries.
Blood Tests: To look for signs of inflammation, such as elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Also to rule out other conditions.
Imaging Studies:
Angiography (CTA, MRA, Conventional Angiography): To visualize the aorta and its branches, looking for narrowing, widening, or blockages.
Ultrasound: To assess blood flow in arteries and look for wall thickening.
PET/CT Scan: To detect areas of active inflammation in the arteries.
Artery Biopsy: Rarely performed but can confirm the diagnosis.
Timeline of Symptoms
The timeline of symptoms is variable, but generally follows this pattern:
Early Stage (Weeks to Months): Nonspecific systemic symptoms such as fever, fatigue, weight loss, and joint pain. These may be subtle and easily mistaken for other illnesses.
Intermediate Stage (Months to Years): Vascular symptoms start to appear as arteries are affected, such as limb pain with exertion, dizziness, headaches, and blood pressure differences.
Late Stage (Years): Complications develop due to reduced blood flow to organs, such as heart failure, stroke, kidney problems, and vision loss.
Important Considerations
Early diagnosis and treatment are crucial to prevent irreversible artery damage and complications.
Takayasu arteritis can affect women of childbearing age, and pregnancy requires careful management due to the potential risks to both mother and baby.
Long-term follow-up is necessary to monitor disease activity, adjust medications, and screen for complications.
A multidisciplinary approach involving rheumatologists, cardiologists, vascular surgeons, and other specialists is often needed to provide comprehensive care.
Research is ongoing to better understand the causes and develop more effective treatments for Takayasu arteritis.