Takayasu Arteritis

Abstract

Takayasu arteritis (TA) is an inflammatory disease of the aorta and its primary branches that affects mainly young women. The arterial involvement may cause ischemic manifestations such as limb or abdominal claudication, visual or cerebrovascular symptoms or renovascular hypertention. Anuloaortic regurgitation secondary to aortic root dilatation may also occur. The most important parameters for diagnosis are the young age of onset and the clinical or laboratory evidence of inflammation [fever, carotidynia, elevated erythrocyte sedimentation rate (ESR)] and aortography abnormalities. Carotid and other arteries ultrasound studies showing thickened artery walls may help in the diagnosis, but the main tool for diagnosis has long been the aspect of the digital subtraction arteriography. Nowadays, the arteriography has been replaced by other contrasted enhanced arterial image studies, especially angiotomography or angioresonance. The following criteria are suggestive of the disease: (a) the concomitant presence of stenosis and aneurysm in aorta, (b) presence of stenosis of at least one aortic branch such as subclavian, common carotid, inonimate, vertebral, renal or mesenteric, especially if a few centimeters away from the arterial ostium and (c) association of thickening of the aortic wall with branch stenosis. Two diagnostic criteria sets are commonly used to classify patients as TA: the American College of Rheumatology and the Sharma modified Ishikawa’s set.