Takayasu arteritis: a comprehensive review of literature

Takayasu arteritis is an inflammatory pulseless disease of large arteries with unknown etiology which advances in three stages i.e. early systemic, vascular, and burnout stage. It is more prevalent in Asian women of childbearing age. Hypertension, fever, weight loss, arthralgia, limb claudication, light-headedness, and arterial pain are common manifestations. Angiography is a gold standard test to evaluate TA. There is no reliable serological marker has been identified. Control on the inflammatory process and hypertension are two imperative angles to treat the disease. Steroids are most used. Reconstructive surgeries are limited to severe and stenotic lesions. This review aims to report comprehensive evidence about Takayasu arteritis. We conducted an integrative review of theoretical and empirical publications reporting epidemiology, etiopathogenesis, classification, diagnostic evaluation, and management of TA. The authors searched PubMed, Embase, and Scopus until March 2020.  A total of 1104 records found, we included 37 papers for review after reading the articles. Remaining was excluded because of no innovative content, insufficient details, and no clear endpoints. This review of the literature presents comprehensive evidence in all fields of TA. Still, large areas need to be studied for better management of patients with TA.

Takayasu arteritis presenting with massive cerebral ischemic infarction in a 15-year-old girl: a case report

Takayasu arteritis is a relatively rare type of large-vessel arteritis that primarily affects the aorta and its major branches, the coronary arteries, and the pulmonary arteries. Depending on the different groups of blood vessels involved in the disease process, the clinical presentation of Takayasu arteritis varies. Here we report a case of a girl presenting with a debilitating massive cerebral ischemic infarct that turned out to be a relatively rare first presentation of Takayasu arteritis. Case report of 15 years old adolescent female hailing from lower socio-economic status with past history of chronic headache, no significant family history, completely immunized presented with sudden onset weakness of right upper and lower limbs, which progressed over 1day with aphasia (recovering) with deviation of angle of mouth to left side On examination left radial ,carotid artery not palpable. Her laboratory results showed an elevated C-reactive protein and erythrocyte sedimentation rate, and subsequent CT angiography demonstrated narrowing and occlusion of the major branches of her aortic arch. We report the case of a patient with Takayasu arteritis presenting with a massive cerebral ischemic infarct and review the current literature on this topic. Conclusion of takayasu arteritis is a relatively rare disease with various and sometimes devastating clinical manifestations, such as massive cerebral ischemic infarction as in our case. Currently, there are multiple diagnostic tools and treatment options available, and more under investigation. Early, appropriate diagnosis and initiation of proper therapy could avoid further progression and reduce complications of the disease.

Pregnancy in a rare case of Takayasu’s arteritis: a case report

In Takayasu’s arteritis is a rare, chronic idiopathic vasculitis affecting aorta and its major branches, commonly seen in young women of Asian origin. Incidence is 2.6 cases/million/year. Female of reproductive age group are commonly affected. A 32-year female G3A2 with known case of Takayasu arteritis wanted to continue this pregnancy under tremandous social pressure and came for antenatal care at tertiary care hospital. As the pregnancy advanced, she developed uncontrolled hypertension and severe IUGR. At 30 weeks of gestation, elective LSCS had to be done in view of reduced fetal blood flow and severe growth restriction. She delivered male baby of 1 kg which was shifted to NICU. Patient required cardiac intensive care unit for first 48 hrs and later shifted to ward. Postoperative period was uneventful, and patient could be discharged on 8th day. Baby received intensive NICU care and discharged after 1 month with 2 kg weight. Pregnancy with takayasu arteritis requires a multipronged management from gynaecologist, cardiologist, cardiac anaesthetist and neonatologist for favourable maternal and fetal outcome.

Takayasu Arteritis in Young Female Present with Fever and Hypotension

Takayasu arteritis also known as pulseless disease/reverse coarctation of aorta is an uncommon, inflammatory, stenoticdisease of medium and large size arteries, with estimated annual incidence rate of 1.2–2.6 cases per million, most prevalentin adolescent girls and young women. We hereby reporting a clinical case of Takayasu arteritis presented with a complaint offever, headache, right shoulder pain, and low blood pressure; she was dengue positive, no response with symptomatic therapy

Enfermedad de takayasu: a propósito de un caso / Takayasu disease: a case report / Doença de takayasu: relato de um caso

Presentamos un caso de una paciente de 58 años, con enfermedad de Takayasu, también conocida como enfermedad sin pulsos, dicha patología es una enfermedad infrecuente, inflamatoria, granulomatosa vascular y de etiología desconocida que afecta a la aorta y a sus ramas principales, incluyendo la arteria carótida, así como la arteria subclavia, vertebral, renal y coronarias. Afecta a una de cada 200.000 personas. Las mujeres con esta enfermedad superan en número a los hombres por 8 a 1, y la edad de comienzo se encuentra entre los 15 y los 30 años, siendo una de las causas de enfermedad cardiovascular temprana, siguiendo su proceso evolutivo de la enfermedad para terminar en la formación de aneurismas. Su tratamiento es a base de corticoides e inmunosupresores, aunque no hay suficiente evidencia que permita afirmar cual es mejor, en cuanto a eficacia y seguridad, la mayoría de veces queda relegado a criterio del facultativo, sobre todo si hay clara evidencia de la enfermedad.

We present a case of a 58 years with Takayasu disease, or pulseless disease, this illness is a rare disease, inflammatory, vascular granulomatous of unknown etiology that affects the aorta and its main branches, including the carotid artery, and subclavian artery, vertebral, renal and heart. It affects one in 200,000 people. Women with this disease outnumber men by 8-1, and the age of onset is between 15 and 30 years, being one of the causes of early cardiovascular disease, following the evolutionary process of the disease to end in the formation of aneurysms. Treatment is with corticosteroids and immunosuppressants, although there is insufficient evidence that allows us to affirm what is best in terms of efficacy and safety, most often relegated to the physician's secrecy, especially if there is clear evidence of the illness.

Apresentamos um caso de uma paciente de 58 anos com arterite de Takayasu, também chamada de doença sem pulso, esta doença é uma doença rara, inflamatória, granulomatosa vascular e de etiologia desconhecida que afeta a aorta e seus principais ramos, incluindo a artéria carótida assim como a subclávia, vertebral, renal e coronária. Ela afeta uma em 200.000 pessoas. As mulheres com esta doença superam os homens por 8 a 1. A idade do início situa-se entre 15 e 30 anos, sendo uma das causas da doença cardiovascular precoce, na sequência da sua evolução da doença para terminar na formação de aneurisma. O tratamento é baseado nos corticóides e imunossupressores, ainda não há provas suficientes para dizer qual é melhor, em termos de eficácia e segurança, na maioria das vezes é relegado ao critério do médico, especialmente se houver uma clara evidência da doença.

Takayasu Arteritis : A Rare Pulseless Disease

Takayasu arteritis was formerly known as a “pulseless” disease and is a chronic idiopathic vasculitis affecting the large vessels in the body most commonly the aorta. Takayasu arteritis is a rare condition and its acute phase presentation is similar to other conditions making diagnosis difficult.There is a possible relationship that exists between Takayasu arteritis and tuberculosis as both diseases have similar chronic inflammatory lesions and occasionally granulomas on the arterial walls. We present a rare case of a 15 yr old female patient with Takayasu arteritis with tuberculosis .

Interventional Management of High-risk Patients with Takayasu’s Arteritis.

Takayasu’s arteritis is a chronic vasculitis affecting aorta and its branches. We report a case series of Takayasu’s disease. Percutaneous intervention with stent implantation is better choice for stenosis and occlusion of coronary and carotid arteries as well as peripheral lesions, and is increasingly used for the management of Takayasu’s arteritis.

The so-called "pulseless disease"

A 61-year old female patient is presented as a case of the so-called pulseless disease". The underlying pathology was a severe arteriosclerosis with thrombosis of the aorta and arteriosclerotic occlusion of its main branches. The patient had two episodes of cerebral infarction and died after the second attack of a superimposed acute bronchopneumonia. It is suggested that the term "pulseless disease" should not be used to designate a disease entity, but rather a manifestation which may be due to various diseases.(Summary)

The so-called "pulseless disease": report of a case

A 61-year-old female patient is presented as a case of the so-called "pulseless disease." The underlying pathology was a severe arteriosclerosis with thrombosis of the aorta and arteriosclerotic occlusion of its main branches. The patient had two episodes of cerebral infarction and died after the second attack of a superimposed acute bronchopneumonia. It is suggested that the term "pulseless disease" should not be used to designate a disease entity, but rather a manifestation which may be due to various diseases. (Summary)

Pulseless disease case report

A case of "Pulseless Disease" in a young boy with a sudden loss of consciousness for 15 minutes followed by hemiplegia and aphasia, absence of radial pulses on both sides and unobtainable blood pressure on the upper extremities is reported. This boy improved remarkably with triamcinolone. Because no definite etiology is established and because of its response to steroids, we ventured to classify it under the disease entity of "Pulseless Disease" or Takayasus Disease which according to the present concept may be a collagen disease. (Summary)