Takayasu arteritis

Question 1

What vessels are affected with Takayasu arteritis?

Answer 1

Takayasu arteritis is a granulomatous vasculitis of large arteries, primarily affecting the aortic arch and its branches, leading to stenosis, aneurysm formation, occlusion, or coarctation.

Question 2

What histopathological findings are seen in Takayasu arteritis?

Answer 2

Characteristic histopathologic findings include mononuclear infiltrates and granulomatous inflammation of the vascular media, leading to arterial wall thickening and occlusion. Granulomatous inflammation of the vascular media, with mononuclear infiltrates, transmural fibrosis, and narrowing of the arterial lumen.

Question 3

Which population is most commonly affected by Takayasu arteritis?

Answer 3

Young adults aged 20-40 years, particularly Asian females.

Question 4

What are the primary risk factors for Takayasu arteritis?

Answer 4

Young age (20-40 years), female gender, and Asian ethnicity.

Question 5

What are the constitutional symptoms of Takayasu arteritis?

Answer 5

Fever, weight loss, fatigue, and myalgias.

Question 6

What are the dermatological manifestations of Takayasu arteritis?

Answer 6

• Livedo reticularis
• Tender nodules
• Purpura

Question 7

What CNS manifestations are seen with Takayasu arteritis?

Answer 7

vision loss, neurological deficits, stroke.

Question 8

What are the arterial-occlusive symptoms of Takayasu arteritis?

Answer 8

• Claudication
• pulse deficits (carotid, radial, ulnar)
• blood pressure discrepancies between limbs
• tenderness and audible bruits over affected vessels
• Renal artery involvement (higher in Asian populations) overall ranges from 11.5% to 62%

Question 9

What vessel is primarily implicated in Takayasu arteritis?

Answer 9

The aorta.

Question 10

What deadly complications can arise from Takayasu arteritis?

Answer 10

Aortic aneurysms, aortic regurgitation, coarctation, myocardial infarction, stroke.

Question 11

What imaging modality is used to diagnose Takayasu arteritis?

Answer 11

Magnetic resonance angiography (MRA) or computed tomography angiography (CTA) is used to visualize vessel narrowing, aneurysms, or coarctation. Arterial narrowing in TA can manifest as audible bruits, blood pressure discrepancies, pulse deficits, and distal ulcerations.

Question 12

What laboratory findings are commonly seen in Takayasu arteritis?

Answer 12

Elevated inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).

Question 13

What is the first-line treatment for Takayasu arteritis?

Answer 13

Corticosteroids to control inflammation.

Question 14

What other treatments are used for refractory Takayasu arteritis?

Answer 14

Immunosuppressive agents such as methotrexate, azathioprine, mycophenolate mofetil, or tocilizumab.

Question 15

What intervention may be required for severe arterial stenosis or coarctation in Takayasu arteritis?

Answer 15

Angioplasty or stenting.

Question 16

What distinguishes Takayasu arteritis from giant cell (temporal) arteritis?

Answer 16

The pathologic abnormalities in Takayasu arteritis closely resemble giant cell (temporal) arteritis, however, Takayasu arteritis primarily affects younger individuals, whereas giant cell arteritis occurs almost exclusively in patients age ≥ 50.