37 Takayasu and other vasculitides Flashcards
T/F Imaging is a mandatory criterion for Takayasu arteritis (TA)
T
Associated in the initiation of TA
Tb infection
HIV infection
Postinfluenza
Hep B vaccination
Criteria for TA
Angio abn + 1/5
Pulse deficit or claudication
BP discrepancy >10 between ext
Bruit
Htn
Elevated ESR/CRP
Stages of blood vessel disease in TA
Acute, stenotic, fibrotic
MC presentation of TA in children (triad)
Constitutional (fever, wt loss, malaise/fatigue)
Htn
Elevated APRs
TA disease commonly assoc with CNS manif
Supradiaphragmatic aortic arch disease
T/F Majority of children with TA have supra and infra diaphragmatic dse
T
middle aortic syndrom characteristic of infra diaphragmatic TA
Htn, abdominal bruit, abdominal pain
Single MC manif of TA
Renovascular htn
Claudication in TA, MC in adult vs child
Adult
Most important and common PE findings in TA
DEcreased/absent periph pulses
BP discrepancy
Bruit
Htn
Htn in TA, MC in adult vs child
Child
Patho finding in TA
Intramural multinucleated giant cells
Preferred imaging modality for TA, esp for serial ff up
MRI/MRA
Seen in MRI/MRA of active TA
Gadolinium enhancement
MC imaging feature in pediatric TA
Stenosis
RF for dissection in TA
Higher PVAS
Lower alb
Higher neutrophil levels
Of much greater importance in following disease activity than vessel wall thickness in imagingof TA
Development of new lesions
Gold std of lumen imaging in TA
Conventional angio
TA types
Pg 595
MC TA type in children
IV and V
NIH defines active TA as new onset or worsening of 2/4 of the ff
Constitutional w/o other explanation
Inflamm markers
Features of ischemia
Vascular lesions on imaging
TA treatment
immunosupp
anti-htn
anti-plt
surgery
Mainstay of tx of TA
CS
MC Steroid sparing agt for TA
MTX, CYC for severe dse
Should be used with caution in treating TA-related htn because bilateral renal blood flow may be further compromised
ACEi
Indication for surg in TA
Significant stenosis or aneurysms in INACTIVE disease
T/F TA is commonly monophasic
F, chronic relapsing disease, monophasic in only 20-25%
MCC of death in TA
CV
Morbidity in TA is usually due to
Complications caused by stenotic vessels
Constitutes “atypical” Cogan
Ophtha manif other than interstitial keratitis
>2 y between ocular and vestibulo-auditory sympt
Signs of large vessel vasculitis particularly of proximal aorta and AV insufficiency
