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Vasculitic Syndrome: Takayasu’s Arteritis Clinical Presentation:
Focal symptoms related to inflammation of affected vessel:
Cerebrovascular ischemia (brachiocephalic or carotid a.)
MI (coronary a.)
Arm claudication [remember this is a symptom of exertional limb fatigue and pain] (brachiocephalic or subclavian a.)
Hypertension (renal a.)
Takayasu’s Arteritis called “Pulseless disease”…
Carotid and limb pulses diminished or absent (85% patients) at time of diagnosis.
Possible finding of aortic aneurysm with palpation.
Etiology & some Epidemiology:
Idiopathic (from an obscure or unknown cause).
Occurs worldwide, but most commonly reported from Asia and Africa
Most often seen in women < 40 years old.
Takayasu’s arteritis targets the aorta and its major branches.
Uncommonly causes aortic aneurysm or aortic dissection.
Histologic examination of affected areas of arteries shows:
Plasma cells and lymphocytes infiltrating media and adventitia
Disruption of elastic lamina
Distal to the involved vessel, get ischemia that damages tissues.
Steroid and cytotoxic drugs may reduce vascular inflammation and give symptomatic relief.
Surgical bypass of obstructed vessels may be helpful for severe cases.