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How is Takayasu disease diagnosed?
The doctor can find elevated blood pressure in over half of the patients with Takayasu disease. Abnormal sounds of blood movement through narrowed blood vessels can be heard sometimes with a stethoscope. Small notches in the ribs of the back of the chest have sometimes been detected on routine chest X-rays and are felt to be a result of abnormal pulsations of blood vessels in these areas.
The diagnosis is supported by the blood tests, such as a sedimentation rate (sed rate), that suggest inflammation in the body. In fact, elevated blood pressure with an elevated sedimentation rate is distinctly uncommon in children and very helpful in suggesting Takayasu disease as a possible cause. Anemia (low red blood cell count) is frequent.
Takayasu arteritis is ultimately diagnosed with an angiogram of the arteries (arteriogram) whereby a contrast material is injected into the blood vessels which makes them visible by X-ray. With the arteriogram, the doctor can visualize the abnormally narrowed and constricted arteries. The diagnosis of Takayasu disease can be aided by magnetic resonance angiography (MRA, the combination of an MRI scan with angiogram) and CT angiography. These are noninvasive methods of diagnosing and monitoring patients with Takayasu disease.
How is Takayasu disease treated?
The treatment of Takayasu disease involves suppressing the inflammation with cortisone medication (prednisone, prednisolone). While most patients can improve, some do not or relapse. In cortisone-resistant patients, stronger medications which suppress the immune system (immunosuppressive drugs), thereby further decreasing active inflammation of the arteries, have been used. Examples include methotrexate (Rheumatrex, Trexall), cyclosporine, cyclophosphamide (Cytoxan), and azathioprine (Imuran). Strict control of elevated blood pressure (hypertension) is important.