MEDICAL DISCLAIMER:The contents are under continuing development and improvements and despite all efforts may contain errors of omission or fact. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice by healthcare workers or laypeople. It is for educational purposes only. Please adhere to your local protocols. Use the BNF for drug information. If you are unwell please seek urgent healthcare advice. If you do not accept this then please do not use the website.

Takayasu's arteritis

Learning objectives

  • Learning
  • Understand
  • Integrate
  • Reflect

  • It is a rare, chronic large-vessel arteritis
  • TA affects those under the age of 50. It is rare.
  • There is a chronic granulomatous pan-arteritis of the aorta
  • Also affects its major branches and pulmonary artery
  • Resulting in focal areas of stenosis, occlusion and aneurysmal formation
  • When arterial branches occlude the patient presents with stroke.
  • Systemic symptoms such as arthralgia, fever, weight loss and rashes and headache.
  • There may be a difference in BP between arms.
  • When arterial branches occlude the patient presents with stroke.
Diagnostic Criteria
Takayasu's arteritis may be diagnosed when at least three of these six criteria are present (sensitivity of 90.5% and a specificity of 97.8%) [Arend et al. 1990]
1 Age at disease onset <50 years
2 Claudication of extremities
3 Decreased brachial artery pulse
4 Blood pressure [systolic] difference > 10mmHg between arms
5 Bruit over subclavian arteries or abdominal aorta
6 Arteriographic narrowing or occlusion of the aorta, its primary branches or large arteries (not due to arteriosclerosis, fibromuscular dysplasia or similar causes)
  • FBC, U&E, ESR and CRP may be elevated.
  • Anti-endothelial antibodies are reported but not specific.
  • DSA is gold standard but often diagnosis made with MRI and MRA, CTA angiography, PET and high-resolution ultrasound.
  • Delayed contrast-enhanced MRI sequences and abnormal 18F-FDG-PET uptake are able to detect vascular inflammation in the pre-stenotic phase.
  • About half respond to systemic steroids. Methotrexate and Azathioprine also used. Biological agents have also been used.
  • Patients are often given anti-platelets and statins and blood pressure is treated. Intervention is sometimes indicated for severe stenosis.
References and further reading