Takayasu arteritis

The autoimmune disease Takayasu arteritis begins very unspecifically with a strong feeling of illness and symptoms, which also occur with conventional viral flu and can lead the attending physician to a wrong diagnosis. The disease then turns into a chronic course in which the symptoms caused by the circulatory disorders come to the fore.

What is Takayasu Arteritis?

The Takayasu arteritis, also Takayasu disease is a very rare autoimmune disease that predominantly affects East Asian women and was named after Mikito Takayasu, who first described the disease in 2008.

Takayasu's arteritis results in a granulomatous, and thus vaso-occlusive, inflammation of the branches of the main artery and, in a few cases, of the pulmonary artery. More rarely, bulges, so-called aneurysms, appear on the affected vessels.

This form of the disease is commonly referred to as vasculitis, a group of diseases that share inflammation of the blood vessels. As a result, the disease often damages the associated organs or limbs, as there is an insufficient supply of them. The vasculid diseases are rheumatic diseases.

causes

The causes of the Takayasu arteritis are still largely unclear today. Autoimmunological processes are suspected. The discussion includes environmental factors, hepatitis viruses, as well as bacterial infections with Staphylococcus aureus.

A genetic predisposition to the disease cannot be ruled out either. How it ultimately leads to vascular occlusion in Takayasu arteritis has now been clarified. After a constriction of the vessels on the vessel walls due to an accumulation of inflammatory cells, the accumulation of cells creates areas that are exposed to high pressure.

The vessel walls calcify, scar tissue is created and as a result the vessels become stiff and narrow.

Symptoms, ailments & signs

A distinction must be made between symptoms in the beginning and advancing stage of Takayasu arteritis. In the beginning there are usually general symptoms that cannot be clearly associated with an inflammation of the blood vessels. Some non-medical professionals mistakenly interpret this as [[flu].They lead to a weakening of the body. Patients complain of febrile conditions.

It is not uncommon for people to sweat at night. Without a lifestyle change, sufferers lose weight. Pain is near the foci of inflammation. The joints and muscles feel damaged. As the disease progresses, new vascular occlusions develop. Often patients then complain of pain in their arms.

Even lifting light objects can become a burden. In this context, dizziness is not uncommon. The natural blood circulation is disturbed. If the carotid artery is affected, the neck feels sore. The pain there is often accompanied by spontaneous visual disturbances. There is a risk of a stroke.

Sometimes people who have Takayasu's arteritis have difficulty breathing and chest pain. It is precisely these symptoms that must not be disregarded. They are fatal if not handled properly. An early healing of the typical signs brings the greatest chance of improvement.

Diagnosis & course

Usually the Takayasu arteritis with a strong feeling of illness. The patients feel very exhausted and weak, suffer from loss of appetite and weight loss and report joint and muscle pain. You may have a fever and night sweats.

After the initial illness, the circulatory disorders and the insufficient supply of the organs concerned lead to chronic complaints such as visual disturbances, dizziness and fainting, high blood pressure and headaches. The risk of stroke and heart attack also increases. The blood pressure in both arms is often different.

With an ultrasound examination, the vascular constrictions and inflammatory processes can be made visible. A computer or magnetic resonance tomography can provide a more precise picture of the vascular system and also make any bulges on the vessels visible.

Since there are no disease-specific laboratory values ​​for Takayasu arteritis, the examination of the blood is not the focus of the diagnosis. Only increased inflammation parameters, such as the C-reactive protein (CRP) and the fibrogen, an accelerated blood sedimentation, as well as the increase in white blood cells can be detected with a laboratory result.

Complications

People with Takayasu's arteritis develop severe joint and muscle pain relatively quickly. Serious complications can arise if the circulatory disorders are not treated. Damage to the heart valve on the main artery can then develop and the risk of heart attack increases. Organ damage and strokes also occur again and again in the course of the disease.

Many people affected also suffer from recurring attacks of dizziness and fainting, which can lead to falls and serious injuries. If the sick person has a previous illness, the typical bouts of fever can already lead to serious complications. Circulatory failure is relatively rare, but if there are accompanying symptoms it can be fatal for the person concerned.

Drug treatment usually proceeds without major complications. However, the immunosuppressants and corticoids used can cause side effects, interactions and allergic reactions. An intervention via balloon catheter, laser or stent can cause vascular damage and other undesirable events.

If a stent is placed in the area of ​​the main artery, this can lead to cardiac arrhythmias. Acute occlusion of the stent and a heart attack can rarely occur. Furthermore, hypersensitivity reactions to the contrast agent can occur.

When should you go to the doctor?

People who suffer from a general feeling of illness or malaise should speak to their doctor about the observations. The illness is often confused with symptoms of the flu, so the person affected should carefully examine and describe the symptoms they are experiencing. Patients often notice differences in their current state of health in comparison to flu at an early stage. You should inform your doctor accordingly.

Fever, night sweats or spontaneous disturbances of the usual vision should be examined and treated. Pain in the chest or upper body is considered unusual and a sign of an existing condition. Impairments in breathing, internal irritation and general weakness must be presented to a doctor. A decrease in normal performance and an increase in the need for sleep are evidence of an existing health disorder. Since the person concerned can die prematurely in the event of a severe course of the disease, the body should react accordingly as soon as the first warning signals are given.

See a doctor as soon as you experience shortness of breath or a racing heart. Anxiety, the feeling of insufficient oxygen in the organism and a pale appearance should be examined and treated. In the event of a loss of internal strength or the impossibility of moving without help, a doctor's visit is necessary.

Treatment & Therapy

The standard therapy for a Takayasu arteritis is a long cortisone treatment. First, the corticoids are used in high doses to curb the inflammation of the blood vessels.

The dose is then slowly reduced as far as possible and continued for at least 6 months to two years before discontinuation of the cortisone can be considered under strict medical supervision with regular blood tests. If the corticoids do not bring the desired success, treatment with immunosuppressants is indicated on a trial basis, although the effectiveness of such a therapy has not yet been clinically confirmed. When there is a risk of vascular occlusion, operations with lasers or balloon catheters are often carried out, in which an attempt is made to reopen the vessel.

A stent can also be used to stabilize a vessel. Untreated Takayasu arteritis leads to death in most cases. However, if therapy is started early, the prognosis for those affected is very good. The survival rate after 10 years is more than 90 percent. Serious complications occur in about 25 percent of the sick.

prevention

To the Takayasu arteritis Due to the fact that the cause of the disease is largely unclear nowadays, only general recommendations for a healthy lifestyle can be given, such as adequate exercise, a healthy, wholesome diet, avoiding tobacco products and drinking alcohol Dimensions.

Aftercare

In most cases, the person affected with Takayasu arteritis has only a few and only limited options for follow-up care. The person concerned should first and foremost consult a doctor at an early stage so that there are no complications or other complaints in the further course. The earlier a doctor is consulted, the better the further course of the disease usually is.

Most of those affected depend on a quick surgical procedure. There are no particular complications, and those affected should rest after the procedure and take care of their bodies. Here you should refrain from exertion or stressful activities in order not to unnecessarily burden the body. In the event of side effects or uncertainties, a doctor should always be consulted first, and he should also be consulted if there are any questions.

In many cases, those affected by Takayasu arteritis also need the help and care of their own families. This primarily alleviates or prevents depression and other mental disorders. Whether the Takayasu arteritis will lead to a reduced life expectancy for the person affected cannot be universally predicted. The earlier the disease is detected, the better the further course will usually be.

You can do that yourself

Takayasu's arteritis is treated with drugs and surgery. The most important self-help measure consists in carefully taking the prescribed glucocorticoids and TNF blockers. In addition, unusual symptoms must be reported to the doctor.

A stinging in the limbs, dizziness or pain suggest an aneurysm at risk of rupture, which must be treated surgically. After an operation it is important to adhere to the doctor's instructions. A change in diet can further reduce the risk of an aneurysm. Patients should eat a healthy diet and avoid eating fatty or high-sugar foods. It is best to consult a nutritionist who can provide additional nutrition tips and create a nutrition plan.

The doctor responsible can also put you in touch with a physiotherapist, who can give tips on physiotherapy measures. If the measures mentioned are observed, the prognosis is good. According to a study, two-thirds of patients can lead a relatively symptom-free life, but must continue to take the medication prescribed by their doctor to rule out serious complications.

In the case of an aneurysm, emergency medical care is necessary. The patient must then be treated in the hospital. It is important to stop the bleeding in order to avoid serious health complications, including death of the patient.