Takayasu's arteritis (patient information): Difference between revisions

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'''For the  WikiDoc page for this topic, click [[Takayasu's arteritis|here]]'''
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{{SI}}
'''For the WikiDoc page for this topic, click [[Takayasu's arteritis|here]]'''


'''Editor-in-Chief:''' Alexandra M. Palmer
{{CMG}}; {{AE}} {{SHH}}


==Overview==
In Takayasu's arteritis [[Symptom|symptoms]] may include arm [[Muscle weakness|weakness]] or pain with use, [[Chest pain]], [[Dizziness]], [[Fever]], [[Arthralgia|joint]] or [[Myalgia|muscle pain]], vision changes, [[Hypertension|high blood pressure (hypertension)]]. Takayasu arteritis appears to be an [[Autoimmunity|autoimmune]] condition. This means the body's [[immune system]] mistakenly attacks healthy tissue. The disease occurs mainly in children and women between the ages of 20 to 40. It is more common in people of East Asian, Indian or Mexican descent. The diagnosis is made when a person has [[Symptom|symptoms]] and [[imaging]] showing [[blood vessel]] narrowing suggesting [[inflammation]]. Possible tests include [[Angiogram]], [[Complete blood count|Complete blood count (CBC)]], [[Electrocardiogram|electrocardiogram (ECG)]], [[Magnetic resonance angiography|magnetic resonance angiography (MRA)]], [[Magnetic resonance imaging|magnetic resonance imaging (MRI)]]. Most people are first treated with high doses of [[Steroid|steroids]]. [[Immunosuppressive drug|Immunosuppressive drugs]], such as [[azathioprine]], [[mycophenolate]], [[methotrexate]], or [[leflunomide]] are often added. Biologic agents including [[TNF inhibitor|TNF inhibitors]] such as [[infliximab]] are recommended for people who do not improve with the previous treatment. [[Surgery]] or [[angioplasty]] may be used to open up narrowed [[Artery|arteries]] to supply [[blood]] or open up the constriction. [[Complication (medicine)|Complications]] may include [[Thrombus|blood clot]], [[Heart attack (patient information)|heart attack]], [[Congestive heart failure (patient information)|heart failure]], [[Pericarditis (patient information)|pericarditis]], [[Stroke (patient information)|stroke]], [[Gastrointestinal bleeding]] or pain from blockage of bowel [[Blood vessel|blood vessels]].


==What are the Symptoms of Takayasu's arteritis?==
[[Symptom|Symptoms]] may include:
* Arm [[Muscle weakness|weakness]] or pain with use
* [[Chest pain]]
* [[Dizziness]]/ lightheadedness
* [[Fatigue]]
* [[Fever]]
* [[Arthralgia|Joint]] or [[Myalgia|muscle pain]]
* Skin [[rash]]
* Night sweats
* Vision changes
* [[Weight loss]]
* Decreased [[Radial artery|radial]] pulses (at the wrist)
* Difference in [[blood pressure]] between the two arms
* [[Hypertension|High blood pressure (hypertension)]]


==What is Takayasu's arteritis?==
==What Causes Takayasu's arteritis?==
'''Takayasu's  arteritis''' is an [[inflammation|inflammatory disease]] of unknown [[etiology]] that affects the [[aorta]] and its branches. Although it has been reported worldwide, it shows a  predilection for young Asian women. Females with this disease outnumber  males by 8:1, and the age of onset is typically between 15 and 30 years.  In the Western world, [[atherosclerosis]] is a more frequent cause of obstruction of the aortic arch vessels than  is Takayasu's arteritis.
* The cause of Takayasu arteritis is unknown. The disease occurs mainly in children and women between the ages of 20 to 40. It is more common in people of East Asian, Indian or Mexican descent. However, it is now being seen more often in other parts of the world. Several [[Gene|genes]] that increase the chance of having this problem were recently found.
* Takayasu arteritis appears to be an [[Autoimmunity|autoimmune]] condition. This means the body's [[immune system]] mistakenly attacks healthy tissue. The condition may also involve other organ systems. Takayasu arteritis has many features that are similar to [[Temporal arteritis|giant cell arteritis (temporal arteritis)]] in older people.


==What are the  symptoms of Takayasu's  arteritis?==  
== Diagnosis ==
About half of all patients develop an initial systemic illness with [[symptom]]s of [[malaise]], [[fever]], [[sleep  hyperhidrosis|night sweats]], [[weight loss]], [[arthralgia]], and [[fatigue  (physical)|fatigue]]. There is often an [[anemia]] and marked elevation of the [[Erythrocyte sedimentation rate|ESR]]. This phase gradually subsides  and is followed by a more [[chronic (medicine)|chronic]] stage characterized by inflammatory and obliterative changes in the  aorta and its branches. The other half of patients with Takayasu's  arteritis present with only late vascular changes, without an antecedent  systemic illness. In the late stage, weakness of the arterial walls may  give rise to localized [[aneurysm]]s.
* There is no [[blood test]] available to make a definite diagnosis.
* The diagnosis is made when a person has [[Symptom|symptoms]] and [[imaging]] showing [[blood vessel]] narrowing suggesting [[inflammation]].
* Possible tests include:
** Arteriogram
** [[Angiogram]]
** [[Complete blood count|Complete blood count (CBC)]]
** [[C-reactive protein|C-reactive protein (CRP)]]
** [[Electrocardiogram|Electrocardiogram (ECG)]]
** [[Erythrocyte sedimentation rate|Erythrocyte sedimentation rate (ESR)]]
** [[Magnetic resonance angiography|Magnetic resonance angiography (MRA)]]
** [[Magnetic resonance imaging|Magnetic resonance imaging (MRI)]]
** [[Computed tomography|Computed tomography (CT)]]
** [[Ultrasound]]
** [[Chest X-ray|X-ray of the chest]]


Four  types of late-phase Takayasu arteritis are described on the basis of  the sites of involvement as follows:<ref>{{cite web |url=http://www.emedicine.com/radio/topic51.htm  |title=eMedicine - Arteritis, Takayasu : Article by Robert L Cirillo,  Jr, MD, MBA |accessdate=2007-07-19 |format= |work=}}</ref>
==When to Seek Urgent Medical Care?==
Call your health care provider if you have [[Symptom|symptoms]] of this condition. Weak [[pulse]], [[chest pain]], and [[breathing]] difficulty require immediate care.


* Type I - Classic pulseless type that  involves the brachiocephalic trunk, carotid arteries, and subclavian  arteries
==Treatment Options==
* Type II - Combination of type I and III
Treatment of Takayasu arteritis is difficult. However, people who have the right treatment can see improvement. It is important to identify the condition early.
* Type III -  Atypical coarctation type that involves the thoracic and abdominal  aortas distal to the arch and its major branches
* Type IV -  Dilated type that involves extensive dilatation of the length of the  aorta and its major branches


==Treatment==
=== MEDICINES ===
The great majority of patients  with Takayasu’s arteritis respond to [[prednisone]]. The usual starting dose is  approximately 1 milligram per kilogram of body weight per day (for most  people, this is approximately 60 milligrams a day). Because of the  significant [[Adverse  effect  (medicine)|side effects]] of long-term high–dose  prednisone  use, the starting dose is tapered over several weeks to a  dose that the  [[physician]]   feels is tolerable for the patient.
* Most people are first treated with high doses of [[Steroid|steroids]]. [[Immunosuppressive drug|Immunosuppressive drugs]], such as [[azathioprine]], [[mycophenolate]], [[methotrexate]], or [[leflunomide]] are often added.
* Biologic agents including [[TNF inhibitor|TNF inhibitors]] such as [[infliximab]] are recommended for people who do not improve with the previous treatment.
* Other biologic agents that show promising benefits for treating Takayasu's arteritis include [[tocilizumab]], and [[rituximab]].


==Where to find medical care for Takayasu's arteritis==
=== SURGERY ===
[http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|Takayasu's arteritis}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed  Directions to Hospitals Treating Takayasu's  arteritis]
* [[Surgery]] or [[angioplasty]] may be used to open up narrowed [[Artery|arteries]] to supply [[blood]] or open up the constriction.
* Aortic valve replacement may be needed in some cases.
 
==Where to find Medical Care for Takayasu's arteritis?==
Medical care for Takayasu's arteritis can be found [https://www.google.com/maps/search/hospitals/ here].
 
==Prevention==
There are no established measures for the [[Prevention (medical)|prevention]] of Takayasu's arteritis.
 
==What to Expect (Outlook/Prognosis)?==
This disease can be fatal without treatment. However, a combined treatment approach using medicines and [[surgery]] has lowered [[Mortality rate|death rates]]. Adults have a better chance of [[Survival analysis|survival]] than children.
 
==Possible Complications==
[[Complication (medicine)|Complications]] may include:
* [[Thrombus|Blood clot]]
* [[Heart attack (patient information)|Heart attack]]
* [[Congestive heart failure (patient information)|Heart failure]]
* [[Pericarditis (patient information)|Pericarditis]]
* [[Aortic regurgitation|Aortic valve insufficiency]]
* [[Pleurisy|Pleuritis]]
* [[Stroke (patient information)|Stroke]]
* [[Gastrointestinal bleeding]] or pain from blockage of bowel [[Blood vessel|blood vessels]]


==Sources==
==Sources==
{{Reflist}}


http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm
[[Category:Medicine]]
[[Category:Rheumatology]]
[[Category:Up-To-Date]]


{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Patient information]]

Latest revision as of 18:02, 27 April 2018

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Overview

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For the WikiDoc page for this topic, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2]

Overview

In Takayasu's arteritis symptoms may include arm weakness or pain with use, Chest pain, Dizziness, Fever, joint or muscle pain, vision changes, high blood pressure (hypertension). Takayasu arteritis appears to be an autoimmune condition. This means the body's immune system mistakenly attacks healthy tissue. The disease occurs mainly in children and women between the ages of 20 to 40. It is more common in people of East Asian, Indian or Mexican descent. The diagnosis is made when a person has symptoms and imaging showing blood vessel narrowing suggesting inflammation. Possible tests include Angiogram, Complete blood count (CBC), electrocardiogram (ECG), magnetic resonance angiography (MRA), magnetic resonance imaging (MRI). Most people are first treated with high doses of steroids. Immunosuppressive drugs, such as azathioprine, mycophenolate, methotrexate, or leflunomide are often added. Biologic agents including TNF inhibitors such as infliximab are recommended for people who do not improve with the previous treatment. Surgery or angioplasty may be used to open up narrowed arteries to supply blood or open up the constriction. Complications may include blood clot, heart attack, heart failure, pericarditis, stroke, Gastrointestinal bleeding or pain from blockage of bowel blood vessels.

What are the Symptoms of Takayasu's arteritis?

Symptoms may include:

What Causes Takayasu's arteritis?

  • The cause of Takayasu arteritis is unknown. The disease occurs mainly in children and women between the ages of 20 to 40. It is more common in people of East Asian, Indian or Mexican descent. However, it is now being seen more often in other parts of the world. Several genes that increase the chance of having this problem were recently found.
  • Takayasu arteritis appears to be an autoimmune condition. This means the body's immune system mistakenly attacks healthy tissue. The condition may also involve other organ systems. Takayasu arteritis has many features that are similar to giant cell arteritis (temporal arteritis) in older people.

Diagnosis

When to Seek Urgent Medical Care?

Call your health care provider if you have symptoms of this condition. Weak pulse, chest pain, and breathing difficulty require immediate care.

Treatment Options

Treatment of Takayasu arteritis is difficult. However, people who have the right treatment can see improvement. It is important to identify the condition early.

MEDICINES

SURGERY

  • Surgery or angioplasty may be used to open up narrowed arteries to supply blood or open up the constriction.
  • Aortic valve replacement may be needed in some cases.

Where to find Medical Care for Takayasu's arteritis?

Medical care for Takayasu's arteritis can be found here.

Prevention

There are no established measures for the prevention of Takayasu's arteritis.

What to Expect (Outlook/Prognosis)?

This disease can be fatal without treatment. However, a combined treatment approach using medicines and surgery has lowered death rates. Adults have a better chance of survival than children.

Possible Complications

Complications may include:

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm

Template:WH Template:WS