Takayasu's arteritis

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Clinic

  • TA, also known as Aortic arch syndrome/ Nonspecific aortoarteritis / Pulseless disease
  • It is a form of large vessel granulomatous vasculitis with massive intimal fibrosis and vascular narrowing,
  • It mainly affects the aorta and its branches, as well as the pulmonary arteries.


Sign and symptoms

  • Systemic illness with signs and symptoms of malaise, fever, night sweats, weight loss, joint pain, fatigue, and fainting. Fainting may result from subclavian steal syndrome or carotid sinus hypersensitivity.
  • Anemia
  • Marked elevation of the ESR or C-reactive protein (nonspecific markers of inflammation).
  • The initial "inflammatory phase" is often followed by a secondary "pulseless phase". It is characterized by vascular insufficiency from intimal narrowing of the vessels manifesting as arm or leg claudication,
  • Renal artery stenosis causing hypertension, and neurological manifestations due to decreased blood flow to the brain.
  • Ocular manifestation
    • Visual loss or field defects
    • Retinal hemorrhages
  • Neurological abnormalities

Related entities

  • Tonsillitis
  • Tuberculous lymphadenitis of the neck
  • Hepatitis B
  • Pyoderma gangrenosum Erythema nodosum
  • Thyroiditis
  • Crohn disease, and Ulcerative colitis

Complications

  • It leads to arterial stenosis, thrombosis, and aneurysms.
  • There is irregular fibrosis of the blood vessels due to chronic vasculitis, leading to sometimes massive intimal fibrosis (fibrosis of the inner section of the blood vessels).

Miasms

MTB [1]

EBV [2]

VZV (maybe) [3]

  1. Al-Aghbari K, Al-Motarreb A, Askar F. Takayasu's Arteritis Associated with Tuberculosis in a Young Yemeni Woman. Heart Views. 2010 Oct;11(3):117-20. doi: 10.4103/1995-705X.76804. PMID: 21577380; PMCID: PMC3089823.
  2. Murakami K, Ohsawa M, Hu SX, Kanno H, Aozasa K, Nose M. Large-vessel arteritis associated with chronic active Epstein-Barr virus infection. Arthritis Rheum. 1998 Feb;41(2):369-73. doi: 10.1002/1529-0131(199802)41:2<369::AID-ART22>3.0.CO;2-S. PMID: 9485096.
  3. Procop GW, Eng C, Clifford A, Villa-Forte A, Calabrese LH, Roselli E, Svensson L, Johnston D, Pettersson G, Soltesz E, Lystad L, Perry JD, Blandford A, Wilson DA, Hoffman GS. Varicella Zoster Virus and Large Vessel Vasculitis, the Absence of an Association. Pathog Immun. 2017;2(2):228-238. doi: 10.20411/pai.v2i2.196. Epub 2017 Jun 6. PMID: 28758156; PMCID: PMC5531613.