Diagnosis and management of Takayasu arteritis

Takayasu arteritis is a panaortitis, more frequent in Japan, South-East Asia India and Mexico, that presents in the 2nd or 3rd decade of life with a non-specific inflammatory phase, then vascular stenosis with ‘pulselessness’ with collateral development. Clinical features include reduced/absent pulses, bruits, hypertension, aortic regurgitation, neurological symptoms from ischemia. While the gold standard for diagnosis is arteriography, magnetic resonance angiography and ultrasonography are now widely used due to their non-invasive nature. Steroids are the cornerstone of medical therapy; cytotoxics may be used for failures. Surgery or angioplasty may be needed for severe vascular stenosis.