Understanding Takayasu's Arteritis: Symptoms, Causes, Diagnosis, and Treatment

Takayasu's arteritis is a rare condition that causes inflammation in large and medium-sized arteries, primarily affecting the aorta and its branches. This disorder is most commonly diagnosed in young women between the ages of 15 and 35, with a peak incidence between ages 20 and 30, but it can affect people of all ages and backgrounds. In this article, we'll explore the symptoms, causes, diagnosis, and treatment options for Takayasu's arteritis.

What Is Arteritis?

Arteritis is a general term referring to the inflammation of arteries, which are blood vessels that carry blood away from the heart to the rest of the body. A related condition called vasculitis involves inflammation of blood vessels in general, including both veins and arteries.

Symptoms of Takayasu's Arteritis

Approximately half of all people with Takayasu's arteritis experience a sense of generalized illness, which may include:

• Low-grade fevers

• Swollen glands

• Anemia

• Dizziness

• Night sweats

• Muscle aches

• Arthritis

• Weight loss

• Reduced pulses

• Blood pressure differences

• Arm or leg pain with exercise

• Stroke

As the disease progresses, patients may experience fatigue, pain, or aching in the arms or legs due to reduced blood supply. In rare cases, decreased blood flow can lead to a stroke or heart attack. Some patients may also experience abdominal pain after meals or high blood pressure due to reduced blood flow to the intestines or kidneys, respectively.

Causes of Takayasu's Arteritis

The exact cause of Takayasu's arteritis is unknown. However, research suggests that a combination of genetic and environmental factors may play a role in the development of this condition. While Takayasu's arteritis most commonly affects young Asian women, it can occur in people of all ages and ethnic backgrounds.

Diagnosing Takayasu's Arteritis

Diagnosing Takayasu's arteritis involves a combination of factors, including:

• A complete medical history and physical exam to rule out other illnesses with similar symptoms

• Imaging studies, such as MRI, X-rays, and angiograms, to determine the location and severity of vessel damage

• Blood tests

• The presence of a bruit, an unusual sound caused by turbulent blood flow through narrowed blood vessels

Unlike other forms of vasculitis, a biopsy is often not practical for diagnosing Takayasu's arteritis due to the risks associated with surgery on large blood vessels.

Treatment Options for Takayasu's Arteritis

Corticosteroids, often called "steroids," are the most common treatment for Takayasu's arteritis. These medications can be dramatically effective, but they may only be partially effective for some people. As symptoms improve, doctors gradually reduce the dosage of steroids to minimize side effects.

In cases where steroids alone are not sufficient, immunosuppressive drugs like methotrexate may be used. Approximately 50% of patients who had previously relapsed can achieve remission and discontinue steroids when these additional medications are used.

In some cases, biologics like Tocilizumab or Infliximab are used.

Patients with Takayasu's arteritis may also require treatment for high blood pressure, as inadequate control can lead to serious complications like stroke, heart disease, or kidney failure. In some cases, surgical interventions such as angioplasty or bypass operations may be necessary to restore normal blood flow or repair aneurysms.

Outlook and Quality of Life

With proper recognition and treatment, the mortality rate for Takayasu's arteritis in the U.S. and Japan is only about 3% after an average of five years with the disease. Approximately 25% of patients treated at The Cleveland Clinic have an entirely normal lifestyle, while another 25% have had to make some adjustments to their activities. About half have had to modify their jobs, and a small number have become occupationally disabled.

Although Takayasu's arteritis is a treatable disease, and most patients improve, many have to deal with partially or completely disabling consequences. Close follow-up with a doctor is essential to monitor the side effects of medications used to treat the condition.

For more information on Takayasu's arteritis and other forms of vasculitis, visit the following reputable sources:

• American College of Rheumatology - Takayasu's Arteritis

• Vasculitis Foundation - Takayasu's Arteritis

• National Organization for Rare Disorders - Takayasu Arteritis