{"id":3018,"date":"2010-04-12T15:30:51","date_gmt":"2010-04-12T19:30:51","guid":{"rendered":"http:\/\/insidesurgery.com\/?p=3018"},"modified":"2013-07-28T17:30:44","modified_gmt":"2013-07-28T21:30:44","slug":"takayasus-arteritis","status":"publish","type":"post","link":"https:\/\/insidesurgery.com\/2010\/04\/takayasus-arteritis\/","title":{"rendered":"Takayasu’s Arteritis"},"content":{"rendered":"
Pathophysiology<\/strong><\/p>\n 1)<\/strong> inflammation of large arteries (especially aorta and branches) 2)<\/strong> type 1 – involvement of the aortic arch and branches 3)<\/strong> type 2 – involvement of descending thoracic and abdominal aorta and branches 4)<\/strong> type 3 – involvement of both arch and descending aorta and branches 5)<\/strong> other vessels commonly involved – retinal, CNS, and pulmonary arteries<\/p>\n Signs and Symptoms<\/strong><\/p>\n 1)<\/strong> dizziness\/syncope 2)<\/strong> visual problems 3)<\/strong> dyspnea 4)<\/strong> intermittent claudication 5)<\/strong> loss of pulses 6)<\/strong> hypertension 7)<\/strong> arterial bruits 8)<\/strong> fever\/night sweats 9)<\/strong> weight loss 10)<\/strong> malaise 11)<\/strong> arthralgias 12)<\/strong> anorexia 13)<\/strong> pain over involved vessels<\/p>\n Characteristic Test Findings<\/strong><\/p>\n Laboratory<\/em> – 1)<\/strong> increased serum renin (owing to renal artery stenosis) 2)<\/strong> mild anemia 3)<\/strong> increased sed rate 4)<\/strong> increased serum immunoglobulin levels Radiology<\/em> – 5)<\/strong> stenosis and occlusion of affected arteries and aneurysms in aortic arch and distal aorta on arteriogram<\/p>\n Histology\/Gross Pathology<\/strong><\/p>\n 1)<\/strong> thickened, focal, raised, plaques in arteries 2)<\/strong> panarteritis of walls with mononuclear cells, neutrophils, and Langerhans’ cells 3)<\/strong> intimal hyperplasia<\/p>\n Associated Conditions<\/strong><\/p>\n 1)<\/strong> stroke 2)<\/strong> relapsing polychondritis<\/p>\n Inheritance\/Epidemiology<\/strong><\/p>\n 1)<\/strong> 90% of patients are women 2)<\/strong> onset usually before age 30 years 3)<\/strong> most patients are Asian 4)<\/strong> highly variable course with fulminant disease to spontaneous remissions<\/p>\n Treatment<\/strong><\/p>\n 1)<\/strong> early in course – corticosteroids or immunosuppression drugs (especially methotrexate) 2) late treatment – requires surgical bypass or atherectomy<\/p>\n Tips for USMLE<\/strong><\/p>\n 1)<\/strong> almost always affects the subclavian arteries 2)<\/strong> if a 23 year old Japanese woman develops pain over her right carotid artery, a blood pressure of 140\/60 in her left arm and 80\/40 in her right arm and no detectable pulse at her right radial artery, think Takayasu’s<\/p>\n","protected":false},"excerpt":{"rendered":" Pathophysiology 1) inflammation of large arteries (especially aorta and branches) 2) type 1 – involvement of the aortic arch and branches 3) type 2 – involvement of descending thoracic and abdominal aorta and branches 4) type 3 – involvement of both arch and descending aorta and branches 5) other vessels commonly involved – retinal, CNS, […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[63],"tags":[1486,1487,1485,1488,1489],"yoast_head":"\n