Takayasu’s arteritis

Andrews J, Al Nahhas A, Pennell DJ et al. (2004) Non-invasive imaging in the diagnosis and management of Takayasu s arteritis. Ann Rheum Dis 63 995-1000... 

Tenderness of the branches of the external carotid artery (occipital, facial, superficial temporal) points towards giant cell arteritis. Tenderness of the common carotid artery in the neck can occur in acute carotid occlusion but is more Ukely to be a sign of dissection, or arteritis. Absence of several neck and arm pulses in a young person occurs in Takayasu s arteritis (Ch. 6). Delayed or absent leg pulses suggest coarctation of the aorta or, much more commonly, peripheral vascular disease. Other causes of widespread disease of the aortic arch are atheroma, giant cell arteritis, syphihs, subintimal fibrosis, arterial dissection and trauma. 

Inflammatory conditions Primary angiitis Systemic lupus erythematosus Temporal arteritis Takayasu s arteritis... 

Giant cell arteritis carmot be differentiated from Takayasu s arteritis in morphological terms. Only the distribution of the lesions with predominance in supra-aortic vessels is indicative for this type of arteritis. 

Takayasu s arteritis can affect the whole aorta and its side branches. In the acute stage of the disease, CT and MRI show an inflammatory thickening of the aortic waU, with increased contrast enhancement. This enables the differentiation from atherosclerotic transformations of the aortic wall. In MRI, edema of the waU can additionally be detectable (Yamada et al. 1998). In chronic stages of the disease (weeks to months), long-segment stenosis of occlusion with the formation of collateral circulation, intraluminal thrombi, and calcifications of the aortic wall can be seen. The incidence of aortic aneurysms in Takayasu s arteritis lies between 30 and 50%... 

Other situations Situations such as a pheochro-mocytomaand coronary arteritis secondary to systemic diseases, as Takayasu s disease, Kawasaki s disease, Churg-Strauss syndrome, etc., may generate myocardial ischaemia, ACS and even a myocardial infarction. This is also the case for patients with AIDS that often present diffuse and severe atherosclerotic lesions. 

Pfefferkorn T, Bitterling H, Htifner K, Opherk C, Schewe S, Pfister HW, Straube A, Dichgans M Malignant hemispheric infarction in takayasu arteritis. J Neurol 2008 255 pp. 1425-1426. 

Wintersperger B, Jakobs T, Herzog P, Schaller S, Nikolaou K, Suess C, Weber C, Reiser M, Becker C (2005) Aorto-iliac multidetector-row CT angiography with low kV settings improved vessel enhancement and simultaneous reduction of radiation dose. Eur Radiol 15 334-341 Yamada I, Nakagawa T, Himeno Y, Numano F, Shibuya H (1998) Takayasu arteritis evaluation of the thoracic aorta with CT angiography. Radiology 209 103-109... 

Horai Y, Satoru O, Lapalme-Remis S, Sumiyoshi R, Nakashima Y, Suzuki T, et al. Takayasu arteritis developing during treatment of ulcerative colitis with infliximab. Mod Rheumatol 2013 23(3) 572-6. 

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