Torching Takayasu’s Arteritis
You feel weak. You occasionally feel feverish. Your joints ache. You could suffer from Takayasu’s arteritis.
Takayasu’s arteritis is a rare inflammatory disease of unknown cause that typically strikes women between the ages of 15 and 30. It affects Hispanic and Asian women. It leads to inflammation of the aorta (and its branches) with accompanying malaise, fever, sweats, weight loss, joint pains, fatigue and anemia. The disorder is marked by inflammation and scar formation that blocks blood flow in arteries.
Quite often, it is hard to feel a patient’s pulse. That gives it a more descriptive name, “pulseless disease.” It drains energy from patients and often gives rise to muscle pain. Patients usually have a fever. Night sweats are common.
Affected arteries include the ones that supply blood to your arms and travel through your neck to provide blood to your brain.
According to the Cleveland Clinic, with Takayasu’s arteritis, swelling damages your arteries, making them weak and stretched out. This may lead to an aneurysm. Your arteries can also become inflamed and narrowed, resulting in restricted blood flow. Also blood vessels can become completely blocked (called an occlusion). Rarely, arteries that provide blood flow to your heart, intestines, kidneys and legs may be involved.
Restricted vessels cause reduced blood flow to the areas they supply with blood. The changes that happen in Takayasu’s arteritis are often gradual, allowing other routes of blood flow to develop. These other routes are often smaller “side roads” that may or may not be able to carry as much blood as the original arteries did.
In general, blood flow beyond an area of narrowing is almost always enough to allow tissues to survive. In rare cases, if there is a lack of secondary blood vessels, tissue that doesn’t get blood and oxygen will die.
The cause of Takayasu’s arteritis is unknown. Takayasu’s arteritis may be an autoimmune condition, which means your immune system is attacking itself. Experts believe that some cases of Takayasu’s arteritis may come from a gene you get from both parents. They may not have symptoms because they’re just carrying one copy of the gene. When you inherit that specific gene from both parents, you can get the condition and its symptoms.
To diagnose Takayasu’s arteritis, your medical provider will need to take a complete medical history and a physical examination. Your provider may hear an unusual sound, a bruit, through the stethoscope due to the restriction in your blood vessels. X-rays that show the extent of artery damage will be needed as well along with methods that detect aneurysms.
Your healthcare provider may run a MRI, CT scan, angiography, PET scan and an ultrasound.
Treatments for Takayasu’s arteritis include medicine to control swelling. However, some people may need surgery to create a way around a blocked artery.
Corticosteroids such as prednisone (Rayos or Sterapred) or prednisolone (Flo-Pred or Orapred) are the most common regimens for Takayasu’s arteritis.
Some benefits of corticosteroids are they are often successful in bringing about remission (the absence of active blood vessel swelling). Also, your healthcare provider can reduce the dosage amount to minimize side effects.
Some drawbacks to corticosteroids are they are only partially productive in some people and more than half of all people taking it will have symptoms that return or illness that grows.
Your provider may also designate immunosuppressive medications such as methotrexate (Rheumatrex or Trexall) and azathioprine (Imuran or Azasan).
Taking immunosuppressive drugs in addition to prednisone can help 50 percent of people who experienced a setback get rid of their symptoms and gradually stop taking prednisone.
Some people may take tumor-necrosis factor inhibitors to fight inflammation including etanercept and infliximab.
Overall, about 25 percent of people with Takayasu’s arteritis won’t be able to handle their disease without continual use of medication.
You may experience some side effects with the medication such as being less able to fight an infection and losing bone mass.
In some instances, restriction of arteries to your kidney can cause hypertension (high blood pressure). Your provider can stretch restricted vessel openings with a balloon (angioplasty) or do a bypass operation to renew normal flow to your kidney.
Some people may have serious mobility issues because of restricted blood vessels in their arms and legs. Bypass operations may amend these problems. A surgical repair or bypass may amend an aneurysm. Some people with Takayasu’s arteritis may need an aortic valve replacement.
People who live long lives with this chronic illness need to have regular checkups and modifications to their medication if needed. Providers need to watch out for side effects from medication and perform blood tests.
Staying in contact with your healthcare provider will help you manage symptoms and prevent them from getting worse.
