Takayasu’s Arteritis

What is Takayasu’s arteritis?

Takayasu’s arteritis is a rare variety of inflammatory disease affecting the blood vessels (vasculitis). In this disease the inner wall of the large blood vessels become thick and narrow leading to poor blood supply to different organs. Takayasu’s arteritis is more common in women of Asian origin. Usually young and middle aged females are more commonly affected. The most commonly affected artery in this disease is the aorta, the largest artery of the body which carries blood from the heart to different organs of the body.

Common complications of this disease include raised blood pressure, increased risk of stroke and heart failure. Anti inflammatory drugs like steroids, cytotoxic drugs etc are commonly prescribed to arrest the inflammatory damage in the arterial wall. In severely advanced cases surgical intervention may be required to improve blood supply through the affected arteries.

Signs and Symptoms

The symptoms of Takayasu’s disease can be classified into two stages depending upon the time of appearance. These are :

  • First stage or early symptoms: common presenting symptoms are increased fatigue; drastic otherwise unexplained weight loss, pain in the muscles and joint and fever. In many patients of Takayasu’s arteritis these initial symptoms may not appear at all.
  • Second stage or late symptoms: these symptoms after considerable narrowing of the affected arteries following inflammatory changes in the vessel walls. Poor blood supply to different organs is the main cause behind these symptoms. Patient usually complain of the following symptoms like :
    – Increased weakness and pain in the legs or arms which typically increase with use.
    – Frequent attacks of lightheadedness, fainting, sudden black out even attacks of epileptic fits.
    – Difficulty in remembering past events or new information.
    – Disturbances in vision.
    – Raised blood pressure, often there is difference in blood pressure measured in two arms.
    – Feeble or complete absence of pulse in the wrists because of severe narrowing of the affected arteries, hence this disease is also known as pulseless disease.
    – Anemia leading to pallor.
    – Tiredness.
    – Pain in the left side of the chest due to poor blood supply to the heart and difficulty in respiration due to increased blood pressure in the vessels of the lung tissue (pulmonary hypertension).
    – Balloon like swelling of the affected blood vessels (aneurysm) may occur at advanced stage of the disease which may lead to rupture of the vessel and severe blood loss.

Causes and Risk Factors

The exact cause that lead to inflammation in the arterial wall is not known; however it may occur if the immune system of the body wrongly starts producing antibody against the vessel walls. Aorta and its large branches are most commonly affected. Inflammation leads to thickening of the vessel walls due to scarring and fibrosis. In late stage due to weakening of the walls the affected blood vessel may become dilated (aneurysm) and rupture. Young and middle aged women are at increased risk (about 8 to 9 times)of suffering from Takayasu’s disease in comparison to males.

Drugs and Treatment

The main goal of treatment is to arrest the inflammatory changes in the arterial walls and restore adequate blood supply. This can be done by using anti inflammatory drugs like steroids and cytotoxic drugs. Surgical intervention like bypass surgery, angioplasty and stenting can restore blood flow to an affected area.

 

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