eMedicine Specialties > Neurology > Inflammatory and Demyelinating Diseases

Takayasu Arteritis: Follow-up

Author: Gabriel Bucurescu, MD, MS, Staff Neurologist, Neurology Service, Philadelphia Veterans Affairs Medical Center
Contributor Information and Disclosures

Updated: Sep 17, 2009

Follow-up

Further Inpatient Care

  • Management of Takayasu arteritis is long-term. Inpatient care is limited to managing acute manifestations of the disease, usually resulting in complications from organ failure, stroke, complications of pregnancy, seizures, and intracranial hemorrhage.
  • ICU admission is indicated for patients with critical deterioration.
  • Fetal monitoring is indicated in patients with suspected complications.

Further Outpatient Care

Monitoring long-term immunosuppressive therapy and hypertension control is necessary.

Complications

  • Complications include stroke, intracranial hemorrhage, seizures, graft stenosis and/or occlusion, ischemia, organ failure, complications of hypertension, and fetal injury.
  • Long-term use of corticosteroids can lead to infection, adrenal suppression, cataracts, hyperglycemia, hypertension (which complicates blood pressure control), osteoporosis, and aseptic necrosis.

Prognosis

Prognosis varies according to the severity of the disease and the response to therapy. In some series, mortality is high. Two main North American series showed survival figures of greater than 90%.

Patient Education

Patients need to understand the nature of the disease and the need to take medications to prevent complications. When in remission or in mild forms, patients are tempted to stop the antihypertensive drugs, thus increasing risk of serious neurologic and other systemic complications.

Miscellaneous

Medicolegal Pitfalls

Takayasu arteritis is rare and difficult to diagnose. Initially, symptoms are vague; disease may progress considerably until the angiogram is performed. Some individuals may find fault with the provider if they feel diagnosis was delayed.

Special Concerns

Pregnancy is an important concern; aggressively treat these patients.

 


More on Takayasu Arteritis

Overview: Takayasu Arteritis
Differential Diagnoses & Workup: Takayasu Arteritis
Treatment & Medication: Takayasu Arteritis
Follow-up: Takayasu Arteritis
References
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Further Reading

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Keywords

aortic arch arteritis, aortitis syndrome, pulseless disease, brachiocephalic arteritis, occlusive thromboarteritis, nonspecific arteritis, occlusive thromboaortopathy, TA

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Contributor Information and Disclosures

Author

Gabriel Bucurescu, MD, MS, Staff Neurologist, Neurology Service, Philadelphia Veterans Affairs Medical Center
Gabriel Bucurescu, MD, MS is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, and American Epilepsy Society
Disclosure: Nothing to disclose.

Medical Editor

Sydney Louis, MB, BCh, MD, Emeritus Professor, Department of Neurology, Brown University School of Medicine
Sydney Louis, MB, BCh, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

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Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

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Florian P Thomas, MD, MA, PhD, Drmed, Director, Spinal Cord Injury Unit, St Louis Veterans Affairs Medical Center; Director, National MS Society Multiple Sclerosis Center; Professor, Department of Neurology and Psychiatry, Associate Professor, Institute for Molecular Virology, and Department of Molecular Microbiology and Immunology, St Louis University
Florian P Thomas, MD, MA, PhD, Drmed is a member of the following medical societies: American Academy of Neurology, American Paraplegia Society, and National Multiple Sclerosis Society
Disclosure: Nothing to disclose.

CME Editor

,, Kathy Roarty Placeholder
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Chief Editor

Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Y Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

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