Takayasu Arteritis

Takayasu Arteritis is a chronic, granulomatous inflammatory disease of large elastic arteries, particularly the aorta and its proximal branches. The pathophysiology involves T cell-mediated inflammatory infiltration of the vessel wall, leading to intimal thickening, medial hypertrophy, fibrosis, and vascular remodeling. The disease progresses through an active inflammatory phase followed by a fibrotic phase characterized by stenosis, dilation, and aneurysm formation. Vessel involvement is heterogeneous, with some patients having primarily aortic and proximal branch involvement while others develop more distal disease. Acute phase symptoms include constitutional symptoms (fever, malaise, fatigue), elevated inflammatory markers (ESR, CRP), and progressive vascular involvement. The chronic phase is characterized by vascular narrowing (stenosis) and dilation (aneurysms) leading to organ ischemia and hemodynamic complications. Renal artery involvement causes hypertension. Coronary artery involvement increases myocardial infarction risk. Aortic root involvement leads to aortic regurgitation and heart failure. Neurologic complications can result from carotid or vertebral artery involvement. Diagnosis requires integration of clinical, imaging (angiography, high-resolution ultrasound, CT/MRI), and sometimes histologic findings.