eMedicine Specialties > Rheumatology > Vasculitis

Takayasu Arteritis: Follow-up

Author: Mohammed Mubashir Ahmed, MD, Associate Professor, Department of Medicine, Division of Rheumatology, University of Toledo College of Medicine
Coauthor(s): Robert E Wolf, MD, PhD, Professor Emeritus, Department of Medicine, Louisiana State University Health Sciences Center at Shreveport; Chief, Rheumatology Section, Medical Service, Overton Brooks Veterans Administration Medical Center of Shreveport
Contributor Information and Disclosures

Updated: Feb 14, 2008

Follow-up

Further Outpatient Care

  • Follow-up should be with either a primary care physician or rheumatologist who can follow disease activity and treat the patient medically as needed.
  • A follow-up examination of critical or near-critical stenosis and disease activity with angiography (or MRI or CT angiography) and possibly FDG PET scanning may be necessary. Recognizing that Takayasu arteritis may progress in the absence of clinical findings is important. Periodic imaging may reveal an active disease that requires treatment with immunosuppressive agents.

Prognosis

  • Takayasu arteritis is associated with substantial morbidity and may be life-threatening.
  • Its course usually extends for many years, with varying degrees of activity.
  • Approximately 20% of patients have a monophasic and self-limited disease. In others, Takayasu arteritis is progressive or relapsing/remitting and requires immunosuppressive treatment.
  • The 15-year survival rate has been reported to be 90-95%.

Miscellaneous

Medicolegal Pitfalls

  • Failure to diagnose appropriately
  • Failure to document extent of vascular disease

Special Concerns

  • Pregnancy may be safer during presumed remission of Takayasu arteritis. It may exacerbate hypertension and/or cardiovascular complications and is a greater risk for both maternal and fetal morbidity and mortality.
  • Acknowledgment: I would like to thank my wife, Eisha, and beautiful children Maahum and Nehaal for their love and support in completing this project.
 


More on Takayasu Arteritis

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

  1. Yagi K, Kobayashi J, Yasue S, et al. Four unrelated cases with Takayasu arteritis and CD36 deficiency: possible link between these disorders. J Intern Med. Jun 2004;255(6):688-9. [Medline].

  2. Hoffman GS, Merkel PA, Brasington RD, et al. Anti-tumor necrosis factor therapy in patients with difficult to treat Takayasu arteritis. Arthritis Rheum. Jul 2004;50(7):2296-304. [Medline].

  3. Andrews J, Al-Nahhas A, Pennell DJ, Hossain MS, Davies KA, Haskard DO. Non-invasive imaging in the diagnosis and management of Takayasu's arteritis. Ann Rheum Dis. Aug 2004;63(8):995-1000. [Medline].

  4. Andrews J, Mason JC. Takayasu's arteritis--recent advances in imaging offer promise. Rheumatology (Oxford). Jan 2007;46(1):6-15. [Medline].

  5. Daina E, Schieppati A, Remuzzi G. Mycophenolate mofetil for the treatment of Takayasu arteritis: report of threecases. Ann Intern Med. Mar 2 1999;130(5):422-6. [Medline].

  6. Joh JH, Kim DK, Park KH, Kim DI. Surgical management of Takayasu's arteritis. J Korean Med Sci. Feb 2006;21(1):20-4. [Medline].

  7. Liang P, Hoffman GS. Advances in the medical and surgical treatment of Takayasu arteritis. Curr Opin Rheumatol. Jan 2005;17(1):16-24. [Medline].

  8. Lie JT. Pathology of isolated nonclassical and catastrophic manifestations of Takayasu arteritis. Int J Cardiol. Oct 1 1998;66 Suppl 1:S11-21. [Medline].

  9. Numano F. Takayasu arteritis, Buerger disease and inflammatory abdominal aortic aneurysms: is there a common pathway in their pathogenesis?. Int J Cardiol. Oct 1 1998;66 Suppl 1:S5-10. [Medline].

  10. Numano F, Kobayashi Y. Takayasu arteritis--beyond pulselessness. Intern Med. Mar 1999;38(3):226-32. [Medline].

  11. Rizzi R, Bruno S, Stellacci C, Dammacco R. Takayasu's arteritis: a cell-mediated large-vessel vasculitis. Int J Clin Lab Res. 1999;29(1):8-13. [Medline].

  12. Schmidt WA, Blockmans D. Use of ultrasonography and positron emission tomography in the diagnosis and assessment of large-vessel vasculitis. Curr Opin Rheumatol. Jan 2005;17(1):9-15. [Medline].

  13. Seo P, Stone JH. Large-vessel vasculitis. Arthritis Rheum. Feb 15 2004;51(1):128-39. [Medline].

  14. Sharma BK, Jain S, Sagar S. Systemic manifestations of Takayasu arteritis: the expanding spectrum. Int J Cardiol. Aug 1996;54 Suppl:S149-54. [Medline].

  15. Tanaka F, Kawakami A, Iwanaga N, Tamai M, Izumi Y, Aratake K. Infliximab is effective for Takayasu arteritis refractory to glucocorticoid and methotrexate. Intern Med. 2006;45(5):313-6. [Medline].

  16. Yasuda K. Surgical treatment of Takayasu's Arteritis. Intern Med. Nov 1998;37(11):903-4. [Medline].

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Further Reading

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Keywords

Takayasu arteritis, TA, pulseless disease, Takayasu's disease, Takayasu's arteritis, Takayasu disease, aortic arch syndrome, middle aortic syndrome stenotic lesions, angioplasty, renovascular stenosis, coronary artery stenosis, extremity claudication, cerebral ischemia, critical stenosis, aortic regurgitation, thoracic aneurysm, abdominal aneurysm, percutaneous transluminal coronary angioplasty, PTCA

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Contributor Information and Disclosures

Author

Mohammed Mubashir Ahmed, MD, Associate Professor, Department of Medicine, Division of Rheumatology, University of Toledo College of Medicine
Mohammed Mubashir Ahmed, MD is a member of the following medical societies: American College of Physicians, American College of Rheumatology, and American Federation for Medical Research
Disclosure: Nothing to disclose.

Coauthor(s)

Robert E Wolf, MD, PhD, Professor Emeritus, Department of Medicine, Louisiana State University Health Sciences Center at Shreveport; Chief, Rheumatology Section, Medical Service, Overton Brooks Veterans Administration Medical Center of Shreveport
Robert E Wolf, MD, PhD is a member of the following medical societies: American College of Rheumatology, Arthritis Foundation, and Society for Leukocyte Biology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Elliot Goldberg, MD, Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine
Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American College of Rheumatology
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Assistant Dean for Medical Curriculum, Associate Professor of Medicine, Division of General Internal Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Herbert S Diamond, MD, Professor of Medicine, Temple University School of Medicine; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital
Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, and Phi Beta Kappa
Disclosure: medifocus Honoraria Review panel membership; health dialogs Honoraria Consulting; Merck, Amgen, Biogen, Zimmer, Wyeth, Johnson&Johnson, Stryker, Medtronic, Zimmer.Abbott,  Ownership interest Other; West Penn Allegheny Health System Consulting fee Consulting; Alpharma Honoraria Consulting; Proctor&Gamble Grant/research funds Independent contractor

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