Takayasu Arteritis

Overview
  • Takayasu Arteritis is a primary vasculitis syndrome which primarily affects large and medium-sized arteries. The disease most often affects the aortic arch and its branches although the pulmonary arteries can also be involved.
Epidemiology
  • Takayasu Arteritis generally affects women in their adolescent and young adult years.
Morphology
  • Involved arteries display proliferative or fibrotic thickening of the tunica intima in some cases to the point of narrowing or obliteration of the vascular lumen. A mononuclear cell infiltrate is most commonly observed which is often centered around the tunica adventitia, particularly near the vaso vasorum. In other cases the mononuclear infiltrate is primarily seen in the tunica media and is associated with granulomas that may contain giant cells. When granulomatous inflammation is present, the morphology may be difficult to distinguish from giant cell arteritis which can affect any sized artery. In such cases, diagnosis is largely made based on the differing demographics of the diseases.
Clinical Consequences
  • Clinical Consequences of this disease are primarily due to stenosis or obliteration of involved vessels and consequent downstream hypoperfusion. Many patients display deficient peripheral pulses especially in the upper extremities compared to the lower extremities due to reduced blood flow through the subclavian artery. Poor blood flow through the common carotid artery may result in visual impairment, blindness, or predispose patients to stroke. Reduced blood flow through the renal arteries may result in secondary hypertension.