Takayasu arteritis - Revision history

Rossdonaldson1 at 17:35, 2 August 2023

2023-08-02T17:35:52Z

← Older revision		Revision as of 17:35, 2 August 2023
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	*Diagnosis is often delayed due to the rarity of the disease and varied symptoms		*Diagnosis is often delayed due to the rarity of the disease and varied symptoms
	*The disease process chronically improves and relapses<ref>Hellmann, DB et al. Rheumatologic, Immunologic, & Allergic Disorders. In: Papadakis MA, McPhee SJ, Rabow MW. eds. Current Medical Diagnosis & Treatment 2017 New York, NY: McGraw-Hill</ref>		*The disease process chronically improves and relapses<ref>Hellmann, DB et al. Rheumatologic, Immunologic, & Allergic Disorders. In: Papadakis MA, McPhee SJ, Rabow MW. eds. Current Medical Diagnosis & Treatment 2017 New York, NY: McGraw-Hill</ref>

			{{Primary Vasculitis DDX}}

	==Clinical Features==		==Clinical Features==
	*[[Hypertension]]		*[[Hypertension]]
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	*[[Rheumatoid Arthritis]]		*[[Rheumatoid Arthritis]]
	*[[Sarcoidosis]]		*[[Sarcoidosis]]

	~~{{Primary Vasculitis DDX}}~~

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Differential Diagnosis */

2023-08-02T17:03:20Z

Differential Diagnosis

← Older revision		Revision as of 17:03, 2 August 2023
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Thromboangiitis obliterans\|Thromboangiitis obliterans (Buerger's Disease)]]
	*[[Systemic lupus erythematosus]]		*[[Systemic lupus erythematosus]]
	*[[Syphilis]]		*[[Syphilis]]

Rossdonaldson1: /* Differential Diagnosis */

2023-08-02T17:02:28Z

Differential Diagnosis

← Older revision		Revision as of 17:02, 2 August 2023
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	*[[Syphilis]]		*[[Syphilis]]
	*[[Rheumatoid Arthritis]]		*[[Rheumatoid Arthritis]]
	*[[Behcet's Disease]]
	*[[Sarcoidosis]]		*[[Sarcoidosis]]

Rossdonaldson1: /* Differential Diagnosis */

2023-08-02T17:02:10Z

Differential Diagnosis

← Older revision		Revision as of 17:02, 2 August 2023
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Giant cell arteritis]]
	*[[Thromboangiitis obliterans\|Thromboangiitis obliterans (Buerger's Disease)]]		*[[Thromboangiitis obliterans\|Thromboangiitis obliterans (Buerger's Disease)]]
	*[[Systemic lupus erythematosus]]		*[[Systemic lupus erythematosus]]

Rossdonaldson1: /* Differential Diagnosis */

2023-08-02T17:01:55Z

Differential Diagnosis

← Older revision		Revision as of 17:01, 2 August 2023
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	*[[Behcet's Disease]]		*[[Behcet's Disease]]
	*[[Sarcoidosis]]		*[[Sarcoidosis]]

			{{Primary Vasculitis DDX}}

	==Evaluation==		==Evaluation==

ClaireLewis at 16:00, 18 October 2019

2019-10-18T16:00:43Z

← Older revision		Revision as of 16:00, 18 October 2019
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	*Claudication		*Claudication
	*Bruits		*Bruits
	*[[Visual ~~disturbance~~]]		*[[Visual disturbances]]
	*[[Arthralgia]]s/~~Myalgias~~		*[[Arthralgia]]s/[[Myalgia]]s
	*[[Aortic Regurgitation]]		*[[Aortic Regurgitation]]
	*Weight Loss		*Weight Loss
	*Arterial Aneurysm		*Arterial Aneurysm

	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Giant cell arteritis]]		*[[Giant cell arteritis]]
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	*[[Behcet's Disease]]		*[[Behcet's Disease]]
	*[[Sarcoidosis]]		*[[Sarcoidosis]]

	==Evaluation==		==Evaluation==
	[[File:Takayasu_MRA.png\|thumb\|An MRA showing occlusion of the left subclavian artery and significant narrowing of the left common carotid artery]]		[[File:Takayasu_MRA.png\|thumb\|An MRA showing occlusion of the left subclavian artery and significant narrowing of the left common carotid artery]]
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	*Angiography revealing narrowing/occlusion of large vessels (e.g. Aorta) is the gold standard <ref>Lin, PH et al. Arterial Disease. In: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. Schwartz's Principles of Surgery, 10e New York, NY: McGraw-Hill; 2015.</ref>		*Angiography revealing narrowing/occlusion of large vessels (e.g. Aorta) is the gold standard <ref>Lin, PH et al. Arterial Disease. In: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. Schwartz's Principles of Surgery, 10e New York, NY: McGraw-Hill; 2015.</ref>
	*MRA or CTA can be used as well to appreciate vascular stenoses		*MRA or CTA can be used as well to appreciate vascular stenoses

	==Management==		==Management==
	*Oral [[Prednisone]] 1 mg/kg for the first month followed by a taper		*Oral [[Prednisone]] 1 mg/kg for the first month followed by a taper

ClaireLewis at 22:30, 25 February 2017

2017-02-25T22:30:57Z

← Older revision		Revision as of 22:30, 25 February 2017
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	==Background==		==Background==
	*A vasculitis ~~that affects large vessels leading~~ to fibrosis and narrowing of the vessels <ref>Hellmann, DB et al. Chapter 31. Takayasu Arteritis. In: Imboden JB, Hellmann DB, Stone JH. eds. CURRENT Diagnosis & Treatment: Rheumatology, 3e New York, NY: McGraw-Hill; 2013.</ref>		*Large-vessel [[vasculitis]], leads to fibrosis and narrowing of the vessels <ref>Hellmann, DB et al. Chapter 31. Takayasu Arteritis. In: Imboden JB, Hellmann DB, Stone JH. eds. CURRENT Diagnosis & Treatment: Rheumatology, 3e New York, NY: McGraw-Hill; 2013.</ref>
	*Most often affects women of Asian descent during reproductive age		*Most often affects women of Asian descent during reproductive age
	*Diagnosis is often delayed due to the rarity of the disease and varied symptoms		*Diagnosis is often delayed due to the rarity of the disease and varied symptoms
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	*[[Congestive Heart Failure]]		*[[Congestive Heart Failure]]
	*[[CVA]]		*[[CVA]]
	*Dizziness		*[[Dizziness]]
	*Pulselessness		*Pulselessness
	*Claudication		*Claudication
	*Bruits		*Bruits
	*Visual ~~Disturbance~~		*[[Visual disturbance]]
	*~~Arthralgias~~/Myalgias		*[[Arthralgia]]s/Myalgias
	*[[Aortic Regurgitation]]		*[[Aortic Regurgitation]]
	*Weight Loss		*Weight Loss
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	==Disposition==		==Disposition==
	*~~This will require clinical judgement~~ on ~~a case by case basis~~		*Disposition dependent on presentation and disease severity
	*Patients should have a solid follow up plan with their primary care doctor or rheumatologist prior to discharge		*Admit patients with severe [[aortic regurgitation]], large aortic aneurysm, or other concerning features
	*~~Patients~~ with severe aortic regurgitation, large aortic aneurysm, or ~~another~~ concerning ~~end product of this disease process will likely require inpatient admission with specialty service care~~
	==References==		==References==
	<references/>		<references/>

	[[Category:Rheumatology]] [[Category:Vascular]]		[[Category:Rheumatology]] [[Category:Vascular]]

Devin Smith: /* Management */

2017-02-21T21:05:13Z

Management

← Older revision		Revision as of 21:05, 21 February 2017
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	*Oral [[Prednisone]] 1 mg/kg for the first month followed by a taper		*Oral [[Prednisone]] 1 mg/kg for the first month followed by a taper
	**Taper to approximately 10 mg/day		**Taper to approximately 10 mg/day
	*The addition of [[Methotrexate]] or [[Mycophenolate mofetil]] to [[Prednisone]] therapy may be more effective		*The addition of [[Methotrexate]] or [[Mycophenolate mofetil]] to [[Prednisone]] therapy may be more effective than monotherapy
	*Additional processes (e.g. Hypertension or Congestive Heart Failure) will require disease specific treatments		*Additional processes (e.g. Hypertension or Congestive Heart Failure) will require disease specific treatments
	*In advanced disease processes, Cardiac or Vascular Surgery or Interventional Radiology may be required for angioplasty, stenting, or valvular repair		*In advanced disease processes, Cardiac or Vascular Surgery or Interventional Radiology may be required for angioplasty, stenting, or valvular repair

	==Disposition==		==Disposition==
	*This will require clinical judgement on a case by case basis		*This will require clinical judgement on a case by case basis

Devin Smith at 07:32, 20 February 2017

2017-02-20T07:32:08Z

← Older revision		Revision as of 07:32, 20 February 2017
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	*The disease process chronically improves and relapses<ref>Hellmann, DB et al. Rheumatologic, Immunologic, & Allergic Disorders. In: Papadakis MA, McPhee SJ, Rabow MW. eds. Current Medical Diagnosis & Treatment 2017 New York, NY: McGraw-Hill</ref>		*The disease process chronically improves and relapses<ref>Hellmann, DB et al. Rheumatologic, Immunologic, & Allergic Disorders. In: Papadakis MA, McPhee SJ, Rabow MW. eds. Current Medical Diagnosis & Treatment 2017 New York, NY: McGraw-Hill</ref>
	==Clinical Features==		==Clinical Features==
	*Hypertension		*[[Hypertension]]
	*Congestive Heart Failure		*[[Congestive Heart Failure]]
	*CVA		*[[CVA]]
	*Dizziness		*Dizziness
	*Pulselessness		*Pulselessness
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	*Visual Disturbance		*Visual Disturbance
	*Arthralgias/Myalgias		*Arthralgias/Myalgias
	*Aortic Regurgitation		*[[Aortic Regurgitation]]
	*Weight Loss		*Weight Loss
	*Valvular Regurgitation
	*Arterial Aneurysm		*Arterial Aneurysm
	==Differential Diagnosis==		==Differential Diagnosis==

Devin Smith: Created page with "==Background== *A vasculitis that affects large vessels leading to fibrosis and narrowing of the vessels Hellmann, DB et al. Chapter 31. Takayasu Arteritis. In: Imboden J..."

2017-02-20T07:24:52Z

Created page with "==Background== *A vasculitis that affects large vessels leading to fibrosis and narrowing of the vessels <ref>Hellmann, DB et al. Chapter 31. Takayasu Arteritis. In: Imboden J..."

New page

==Background==
*A vasculitis that affects large vessels leading to fibrosis and narrowing of the vessels <ref>Hellmann, DB et al. Chapter 31. Takayasu Arteritis. In: Imboden JB, Hellmann DB, Stone JH. eds. CURRENT Diagnosis & Treatment: Rheumatology, 3e New York, NY: McGraw-Hill; 2013.</ref>
*Most often affects women of Asian descent during reproductive age
*Diagnosis is often delayed due to the rarity of the disease and varied symptoms
*The disease process chronically improves and relapses<ref>Hellmann, DB et al. Rheumatologic, Immunologic, & Allergic Disorders. In: Papadakis MA, McPhee SJ, Rabow MW. eds. Current Medical Diagnosis & Treatment 2017 New York, NY: McGraw-Hill</ref>
==Clinical Features==
*Hypertension
*Congestive Heart Failure
*CVA
*Dizziness
*Pulselessness
*Claudication
*Bruits
*Visual Disturbance
*Arthralgias/Myalgias
*Aortic Regurgitation
*Weight Loss
*Valvular Regurgitation
*Arterial Aneurysm
==Differential Diagnosis==
*[[Giant cell arteritis]]
*[[Thromboangiitis obliterans|Thromboangiitis obliterans (Buerger's Disease)]]
*[[Systemic lupus erythematosus]]
*[[Syphilis]]
*[[Rheumatoid Arthritis]]
*[[Behcet's Disease]]
*[[Sarcoidosis]]
==Evaluation==
[[File:Takayasu_MRA.png|thumb|An MRA showing occlusion of the left subclavian artery and significant narrowing of the left common carotid artery]]
*Work up should be tailored to the patient's symptoms as this disease process affects multiple organ systems due to vascular damage
===Laboratory===
*ESR, CRP, WBC may or may not be elevated
*Anemia may be present
===Imaging===
*Angiography revealing narrowing/occlusion of large vessels (e.g. Aorta) is the gold standard <ref>Lin, PH et al. Arterial Disease. In: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. Schwartz's Principles of Surgery, 10e New York, NY: McGraw-Hill; 2015.</ref>
*MRA or CTA can be used as well to appreciate vascular stenoses
==Management==
*Oral [[Prednisone]] 1 mg/kg for the first month followed by a taper
**Taper to approximately 10 mg/day
*The addition of [[Methotrexate]] or [[Mycophenolate mofetil]] to [[Prednisone]] therapy may be more effective
*Additional processes (e.g. Hypertension or Congestive Heart Failure) will require disease specific treatments
*In advanced disease processes, Cardiac or Vascular Surgery or Interventional Radiology may be required for angioplasty, stenting, or valvular repair
==Disposition==
*This will require clinical judgement on a case by case basis
*Patients should have a solid follow up plan with their primary care doctor or rheumatologist prior to discharge
*Patients with severe aortic regurgitation, large aortic aneurysm, or another concerning end product of this disease process will likely require inpatient admission with specialty service care
==References==
<references/>

[[Category:Rheumatology]] [[Category:Vascular]]