Autoimmune

Question 1

What is Takayasu’s arteritis?

Answer 1

A rare autoimmune vasculitis disorder which predominantly affects young women.

Question 2

Which vessel does Takayasu’s arteritis most commonly affect, and what are the features of its course?

Answer 2

It is a chronic, progressive, inflammatory, occlusive disease of the aorta and its branches.

Question 3

What happens as a result of in the inflammation to the aorta and its branches in Takayasu’s? (4)

Answer 3

1. Stenosis
2. Occlusion
3. Dilation
4. Aneurysm formation

Question 4

Which HLA type is Takayasu’s most commonly associated with?

Answer 4

B52

Question 5

How does Takayasu’s present if the patient is in the systemic stage of the disease course? (3)

Answer 5

Systemic stage = symptoms of inflammation of the artery prior to any occlusion:

1. Fever, fatigue, weight loss
2. Arthralgia and non-specific pains
3. Tenderness overlying the affected arteries

Question 6

What are the symptoms of the occlusive stage of Takayasu’s arteritis? (5)

Answer 6

1. Vascular - claudication of the jaw or extremities, back pain
2. Neurological - dizziness, headaches, TIA
3. Cardiac - angina, dyspnoea
4. Pulmonary - haemoptysis, pleuritis
5. GI - abdominal pain from ischaemia, infarction of bowel

Question 7

What are the signs of Takayasu’s arteritis? (6)

Answer 7

1. Key finding is a difference in systolic BP between arms
2. Peripheral pulses may not be palpable
3. High BP in over 50% due to renal artery involvement
4. Anaemia
   5 Muscle wasting
5. Skin vasculitis

Question 8

What is the diagnostic investigation for Takayasu’s?

Answer 8

Angiography (conventional, CT or MRI)