Clinical features of Takayasu's Arteritis :?
- It is granulomatous vasculitis affecting medium and larger arteries.
- The disease has a strong predeliction for the aortic arch and its branches. C.) Takayasus arteritis classically involves the "aortic arch".
Transmural involvement (all three layers are involved).
|Media||Mononuclear infiltrates to granulomatous inflammation with giant cells|
|Vasa vasorum||Perivascular cuffing|
- As the disease progresses collagenous scarring with admixed chronic infiltrates occur in all three layers of the vessel wall.
- Narrowing of the lumen occurs with or without thrombosis pathological changes in various organs reflect the compromise of blood flow through the involved vessels.
- Aortic lesions of Takayasu arteritis share many attributes with Giant cell arteritis including clinicalfeatures and histology.
|The distinction is typically made on the basis of the age of the patient|
|50 years||Giant cell Arteritis|
|50 yrs||Takayasu disease|
- Nonspecific features of Vasculitis
- Fatigue, weight loss and fever
- Vascular symptoms (Due to luminal narrowing of the aortic arch).
- Marked weakening of pulses in upper extremities It is also knowns as "pulseless disease".
- Reduced blood pressure in upper extremitiese
- Ocular disturbances
- Visual defects
- Retinal hemorrhages
- Total blindness
- Takayasu disease can also cause Myocardial infarction.
- Due to narrowing of the coronary arteries.
- Hypertension in 50% cases
- Narrowing of renal arteries lead to hypertension in half the cases.
- Diminished pulsein upper extremities and hypertension in a young female suggests a diagnosis of Takayasu arteritis.
|Age at disease onset in year||Development of symptoms of findings related to Takayasu arteritis at age < 40 years|
|Claudication of examination||Development and worsening of fatigue and discomfort in muscles of one or more extremity while in use,
especially the upper extremities.
|Decreased brachial artery pulse||Decreased pulsation of one or both brachial arteries|
|BP differences> 10 mmHg||Difference of> 10 mmHg in systolic blood pressure between arms|
|Bruitover subclavian arteries or aorta||Bruit audible on auscultation over one or both subclavian arteries or abdominal aorta|
|Arteriogram abnormality||Arteriographic narrowing or occlusion of the entire aorta, its primary branches,
or large arteries in the proximal upper or lower extremities, not due arteriosclerosis,
fibro-muscular dysplasia, or similar causes: changes usually focal or segmental
- Takayasu arteritis is diagnosed if at least three of six criteria are present.
- The most commonly affected arteries as seen by arteriography in order of frequency
- Coronary Vertebral (35%)
- Coeliac axis (18%)
- Pulmonary (10-40 %)
- Superior Mesenteric (18%)
- Iliac (17%)
- Subclavian (93%)
- Common Carotid (58%)
- Abdominal Aorta (47%)
- Renal (38%)
- Most common causeof renal artery stenosis in children in India is Takayasu Aortoarteritis
- Takayasu arteritis commonly effects Renal arteries
- Takayasu arteritis are associated with granulomatous pathology
- Most common cause of renovascular hypertension in children in India is Takayasu Aortoarteritis
- Aortic arch syndrome is also known as Takayasu Aortoarteritis
- Takayasu Aortoarteritis is Large vessel vasculitis
- Takayasu Aortoarteritis is Pulseless disease
- Takayasu's arteritis predispoase to Aortic dissection
- A young female presents with diminished pulses in the upper limb and hypertension. The most likely diagnosis is Takayasu's arteritis
- Reversed Coarctation is seen in Takayasu Arteritis
- Takayasu arteritis mainly affects Subclavian artery
- Renal artery stenosis may occur in Takayasu arteritis
- Blood pressure difference between left and right limbs in Takayasu arteritis
- Takayasu arteritis Shows Strongly positive mantoux
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