Takayasu’s arteritis (TA) is a rare, idiopathic, chronic
inflammatory disease with cell-mediated inflammation,
involving mainly the aorta and its major branches. It leads
to stenosis, occlusion or aneurysmal degeneration of large
arteries. The clinical presentation is characterized by an
acute phase with constitutional symptoms, followed, months
or years later, by a chronic phase in which symptoms relate to
fibrosis or occlusion of vessels. Conventional angiography,
the gold standard method for initial diagnosis, appears to
have been replaced with new imaging modalities such as
magnetic resonance angiography (MRA) and 18Ffluorodeoxyglucose
positron emission tomography (FDGPET)
in recent years. These are also used for the assessment
of disease activity. New tools for disease assessment such as
Indian Takayasu’s Arteritis Score 2010 (ITAS2010) and color
Doppler ultrasound (CDUS) aim to better characterize and
quantify disease activity. Leflunomide, tumor necrosis factor
(TNF)-± antagonists, and tocilizumab are new options for
patients resistant to conventional therapies. Prognosis is
possibly getting better, with lower mortality in recent years
due to recent advancement in investigations and
management.
Key words: vasculitis, Takayasu’s arteritis, pulseless disease,
disease assessment, outcome.
(J Bangladesh Coll Phys Surg 2020; 38: 35-45)
DOI: http://dx.doi.org/10.3329/jbcps.v38i1.44687