Takayasu Arteritis Differential Diagnoses

Updated: Nov 14, 2018
  • Author: Jefferson R Roberts, MD; Chief Editor: Herbert S Diamond, MD  more...
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DDx

Diagnostic Considerations

Takayasu arteritis is rare and difficult to diagnose. Initially, symptoms are vague; the disease may progress considerably until an angiogram is performed. Conditions to consider in the differential diagnosis of Takayasu arteritis include the following:

  • Cerebral aneurysms

  • IgG4-related disease [29]

  • Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
  • Intracranial hemorrhage

  • Lacunar syndromes

  • Neurofibromatosis type 1

  • Neurofibromatosis type 2

  • Polyarteritis nodosa

  • Sarcoidosis and neuropathy

  • Subarachnoid hemorrhage

  • Syncope and related paroxysmal spells

  • Fibromuscular dysplasia

  • Spondyloarthropathies

  • Thromboembolism

  • Traumatic stenosis

  • Radiation fibrosis

  • Ergotism

  • Ehlers-Danlos syndrome

  • Marfan syndrome

  • Neurofibromatosis

  • Syphilis

  • Cogan syndrome

  • Dilated cardiomyopathy

  • Erythema nodosum

  • Relapsing polychondritis

  • Amaurosis fugax

  • Ocular pathology

  • Other arteritides

  • Other large vessel diseases (eg, neurofibromatosis of the abdominal aorta)

  • Carotid disease and stroke

  • Reversible posterior leukoencephalopathy syndrome

  • Common variable immunodeficiency syndrome

  • Keratouveitis

  • Posterior scleritis

  • Polymyalgia rheumatica

  • Subclavian steal syndrome

  • Raynaud phenomenon

Case reports describe patients who meet the diagnostic criteria for both Takayasu arteritis and giant cell (temporal) arteritis, although subtle differences exist in the distribution of arterial involvement in the two diseases. [30, 31] Some authors have advanced the notion that the two disorders may represent a spectrum of a single disease, with the manifestations influenced by hormonal, immunologic and vascular factors. [31] Virological and pathological findings and response to antiviral treatment in one patient support a possible etiologic role for varicella-zoster virus (VZV). [30]

Differential Diagnoses