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Takayasu Arteritis (TAK)

Takayasu Arteritis (TAK): Causes, Symptoms, Diagnosis, and Treatment

Takayasu arteritis (TAK) is a rare autoimmune vasculitis that inflames the aorta and its major branches, leading to artery narrowing, aneurysms, or organ damage. It primarily affects young women and requires early diagnosis to prevent severe complications like stroke or heart failure.

Causes of Takayasu Arteritis

The exact cause is unknown, but TAK is linked to:

1. Autoimmune Dysregulation: Immune cells mistakenly attack artery walls.
2. Genetic Predisposition: Higher risk in individuals of East Asian or South Asian descent56.
3. Environmental Triggers: Suspected but unproven associations with infections or hormonal factors5.

Symptoms of Takayasu Arteritis

Symptoms often develop in two phases:

1. Systemic Phase:
   • Fatigue, weight loss, fever, night sweats, muscle/joint pain123.
   • Mild anemia or elevated inflammatory markers (e.g., CRP, ESR)36.
2. Vascular Phase:
   • Claudication: Pain in arms/legs during activity (e.g., arm fatigue when brushing hair)15.
   • Diminished pulses or low blood pressure in limbs16.
   • Hypertension: Due to renal artery stenosis14.
   • Neurological issues: Headaches, dizziness, or vision changes18.
   • Cardiac complications: Angina, heart failure, or aortic regurgitation14.

Asymptomatic Cases: Some patients have no symptoms until advanced artery damage occurs36.

Diagnosis

Diagnosis combines clinical evaluation and imaging:

1. Imaging:
   • CT/MR Angiography: Detects artery stenosis, aneurysms, or wall thickening45.
   • PET Scan: Identifies active inflammation5.
2. Blood Tests:
   • Elevated CRP/ESR: Indicates inflammation36.
   • Anemia: Common in chronic cases3.
3. Clinical Signs:
   • Bruit (abnormal artery sounds) or absent pulses46.

Treatment

TAK is chronic and incurable but manageable with:

1. Immunosuppressants:
   • Corticosteroids (e.g., prednisone) to reduce inflammation45.
   • Methotrexate or mycophenolate: Steroid-sparing agents45.
2. Biologics:
   • TNF inhibitors (e.g., infliximab) or IL-6 inhibitors (e.g., tocilizumab) for refractory cases57.
3. Interventional Procedures:
   • Angioplasty or stenting for stenotic arteries45.
   • Surgical bypass for severe blockages5.

Complications

• Cardiovascular: Aortic aneurysms, heart failure, or stroke18.
• Renal: Hypertension or kidney failure13.
• Neurological: Vision loss or transient ischemic attacks18.

Risk Factors

• Age: Typically diagnosed in women aged 20–4056.
• Ethnicity: Higher prevalence in East/South Asian populations56.
• Sex: ~80% of cases occur in women56.

Conclusion

Takayasu arteritis requires early diagnosis via imaging and aggressive immunosuppression to prevent irreversible artery damage. While incurable, treatment can manage symptoms and reduce long-term risks like stroke or heart failure.

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References

1. MSD Manuals: Takayasu Arteritis
2. Mayo Clinic: Takayasu’s Arteritis
3. PMC: Clinical Manifestations of TAK
4. Johns Hopkins: Takayasu’s Arteritis
5. Brigham and Women’s: TAK Symptoms and Treatment
6. American College of Rheumatology: TAK
7. Cleveland Clinic: TAK
8. Vasculitis Foundation: TAK