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Takayasu's arteritis

Takayasu's arteritis is a rare kind of autoimmune disorder causing swelling in blood vessels near the heart, which can stop blood flow.

Takayasu's arteritis tends to only affect adolescent girls, but the cause of the condition is still not known.

The condition was named after Dr Mikoto Takayasu, the doctor who first described the disorder in 1908.

What are the symptoms of Takayasu's arteritis?

Approximately half of all people with Takayasu's arteritis will have a sense of generalised illness. This may include low grade fevers, swollen glands, anaemia, dizziness, night sweats, muscle aches or arthritis.

The changes that occur in Takayasu's arteritis often are gradual, allowing alternate (collateral) routes of blood flow to develop. These alternate routes often are smaller "side roads". The collateral vessels may not be able to carry as much blood as the normal vessels.

In general, however, the blood flow that occurs beyond an area of narrowing is almost always adequate to allow tissues to survive. In rare cases, if collateral blood vessels are not available in sufficient quantity, the tissue that is supplied with blood and oxygen by those vessels will die.

Narrowing of blood vessels to the arms or legs may cause fatigue, pain or aching due to reduced blood supply, especially during activities such as shampooing the hair, exercising or walking. It is much less common for decreased blood flow to cause a stroke or a heart attack. In some people, decreased blood flow to the intestines may lead to abdominal pain, especially after meals.

Decreased blood flow to the kidneys may cause high blood pressure, but rarely causes kidney failure.

Some people with Takayasu's arteritis may not have any symptoms. Their diagnosis may be discovered when their doctor attempts to take their blood pressure and has trouble getting a reading in one or both arms. Similarly, a doctor may notice that the strength of pulses in the wrists, neck, or groin may not be equal, or the pulse on one side may be absent.

How is Takayasu's arteritis diagnosed?

The diagnosis of Takayasu's arteritis is based on a combination of factors, including:

  • A complete medical history and careful physical examination to exclude other conditions that may have similar symptoms
  • Analysis of imaging studies (such as MRI, X-rays and angiograms), which show location and severity of vessel damage
  • Presence of a bruit. (Significant narrowing of blood vessels may result in turbulent blood flow through the narrowed area that creates an unusual sound called a "bruit.")

With most other forms of vasculitis, a biopsy (tissue sample) of the affected area confirms the presence of blood vessel inflammation. A biopsy is most appropriate when easily accessible areas, such as the skin, are affected. However, when large blood vessels are affected, a biopsy is often not practical because of the risks associated with surgery.

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