Takayasu's disease: symptoms and treatment

Recently, mankind has completely revised its attitude to various kinds of diseases. Many people today prefer a healthy lifestyle, try to eat right, gradually give up harmful habits. Such measures act as the prevention of many ailments. Unfortunately, even the right way of life 100% does not guarantee that a person will not overtake this or that disease.

general information

Takayasu's disease is a rather serious inflammation of chronic nature that is noted in the area of large blood vessels. Their main function is to transfer blood from the heart. Of course, the wrong work of this body has an impact on the entire body. Otherwise, this illness is called a disease of lack of pulse, Takayasu's syndrome or nonspecific aortoarteriitis.

With progressive inflammation of the aorta and its branches, the inner surface of the vessels themselves is gradually damaged. As a consequence, there is a thickening of their central shell. The destruction of the middle smooth muscle is observed. In the aortic lumen, granulomas consist consistently of giant cells. All these processes cause protrusion and expansion of the blood vessel itself, an aneurysm is formed. In the case of further progression of the disease die so-called elastic fibers. As a result, blood flow is gradually disrupted, which entails ischemia of internal organs and tissues. Then on the damaged walls microthrombi and atherosclerotic plaques are formed.

Takayasu disease is mainly diagnosed in girls and women aged 15 to about 25 years. In medicine, cases of manifestation of the disease in male patients are also known.

The first symptoms are usually manifested at the age of 8-12 years. It is important to note that this disease is prevalent in the countries of South America and South-East Asia, but today the cases of Takayasu's syndrome are also registered in more remote regions.

A bit of history

In 1908, an ophthalmologist from the Land of the Rising Sun, M. Takayasu, spoke about the pathological changes in the retinal vessels found during the next examination of a young woman. In the same year, other specialists from Japan noted similar deformities of the fundus in their patients, which was combined with the absence of pulsation of the so-called radial artery. It is noteworthy that the term "Takayasu disease" itself began to be used in medicine only in 1952.

Main reasons

The etiological agent of this ailment is currently unknown. Specialists have identified the relationship of the disease with all known streptococcal infection, actively discusses the role of microbacteria tuberculosis.

Today, scientists believe that the imbalance of the so-called cellular immunity is of primary importance in the formation of autoimmune disorders. It is noteworthy that in the blood of patients, as a rule, there is an increase in the content of CD4 + T-lymphocytes and a decrease in the number of CD8 + T-lymphocytes. Also, specialists diagnose an increase in the number of circulating immune complexes, an increase in the activity of elastase and a special cathepsin G.

How is nonspecific aortoarteritis classified?

Takayasu's disease, based on the anatomy of the lesion, is conditionally divided into several types.

1. The first type. The aortic arch and all branches departing from it are amazed.
2. The second type. The abdominal and thoracic parts of the aorta are affected.
3. The third type. The arch of an aorta together with thoracal and abdominal departments is amazed.
4. The fourth type. The disease involves the pulmonary artery.

Symptoms

First of all, patients begin to complain of the appearance of pain in the hands, weakness, discomfort in the chest and neck. As a consequence, there is a symptomatology characteristic of neurological disorders. For example, distracted attention, reduced efficiency, memory problems.

If the disease is associated with the optic nerve, patients experience a sharp decrease in vision or even blindness (usually only one eye).

Due to changes in the pathological character in the arterial vessels, so-called aortic insufficiency develops. This problem leads to myocardial infarction and violations in the coronary circulation.

With minor changes directly in the abdominal part of the aorta, blood circulation in the leg area worsens significantly, while walking, patients experience discomfort and pain.

When the arteries of the kidneys in the urine are damaged during the next investigation, red blood cells are found. In the future, there is a very high risk of developing renal artery thrombosis.

In case of involvement in the inflammatory process of the pulmonary artery in patients, shortness of breath, pain in the chest area.

In medicine, today there are two stages of the disease: acute and chronic. It is important to note that only a doctor is able to accurately determine the course of the disease. Clinical signs of acute form can be atypical, so timely and correct diagnosis can be very difficult. The thing is that the same manifestations are possible not only with such a disease as Takayasu's disease.

Symptoms of an acute period:

• Weight loss;
• Increased sweating;
• Slight increase in body temperature;
• Fatigue;
• Rheumatic pain in the joints.

The chronic stage, as a rule, develops in 6 years from the moment of the onset of the disease. It is characterized by other clinical signs.

Takayasu's disease manifests itself in the form of frequent headaches, impaired coordination, discomfort along the course of large joints, chronic muscle weakness.

Diagnostics

Confirm the presence of this disease can only be a qualified specialist if the patient has at least three of the following symptoms:

• Disappearance of the pulse in the area of the hands;
• Age over 40 years;
• Between the arterial pressure on the upper limbs difference is not less than 10 mm Hg. P.
• Noises in the aorta;
• Persistent increase in blood pressure;
• Prolonged increase in ESR.

All of the above signs, as a rule, indicate a disease Takayasu. Symptoms may vary slightly and vary in each individual case.

It is important to note that the doctor must necessarily appoint an additional examination of the patient's body . It implies a biochemical / general blood test, which allows you to determine the slightest deviations from the norm, characteristic for this disease. In addition, angiography with the administration of contrast medium will be required. This is a special radiographic study of blood vessels, which allows to determine the sites of narrowing of the arteries. Echocardiography provides an opportunity to assess the work of the heart. No less important is the ultrasound examination of blood vessels. Through ultrasound, the doctor receives a complete picture of the state of the coronary vessels and the rate of blood flow. All of the above diagnostic methods of research can confirm the presence of such a problem as the aortoarteritis of Takayasu.

What should be the therapy?

If we take into account the fact that the disease predominantly progresses in adolescence, treatment can be somewhat difficult. Definitely requires a qualified integrated approach and compliance with some preventive rules. In particularly difficult cases, surgical intervention may be required.

Treatment Takayasu means the use of medicines. To stabilize blood pressure, as a rule, B-blockers and so-called calcium channel blockers are prescribed . To eliminate possible blood clots, patients are advised to take anticoagulants ("Heparin" and others). Therapy of this disease also includes the use of vasodilator drugs and corticosteroids (the drug "Prednisolone", etc.). It is important to note that the latter significantly reduce the autoimmune response from the body.

How else can we overcome Takayasu's disease? Treatment of this disease is possible today through a so-called extracorporal hemocorrection. This is a very complicated procedure. It implies the allocation of special pathological components of blood, which directly and provoke the development of the disease. The processing of these elements takes place outside the patient's body.

Surgery

According to specialists, conservative therapy does not always allow us to overcome Takayasu's syndrome. Symptoms can only be copied for a while. Of course, such measures are not enough, very soon a relapse may occur. That is why, in some cases, doctors strongly recommend surgical intervention, which fully restores the patency of the vascular bed.

The main indications for the operation are:

• Hypertension on the background of a vasorenal syndrome;
• Aortic obstruction;
• The risk of ischemia of the heart.

If we talk about ongoing surgical manipulations, they are most often represented by resection of the pathological segment of the aorta, bypass grafting and endarterectomy. With a qualified approach, the patient almost forgets about what Takayasu syndrome is.

Prevention

Any pathology, as you know, can be prevented, and this disease was no exception. Preventive measures include the timely treatment of all infectious and viral diseases (pharyngitis, tonsillitis, pyelonephritis, etc.). According to experts, the chronic course of these diseases is a favorable basis for the development of Takayasu's syndrome, so patients are at risk.

It is extremely important to strengthen immunity throughout the year. For these purposes, experts recommend taking multivitamin complexes, eating right, doing sports.

Forecast

Adequate and timely treatment significantly reduces the risk of death. Moreover, in 90% of patients, literate therapy prolongs life by about 15 years.

As for complications, most often the main cause of death is stroke (50%) and myocardial infarction (25%).

Conclusion

Patients who have been diagnosed with Takayasu's syndrome should understand that this problem requires long-term treatment with the obligatory observance of all the doctor's recommendations. Otherwise, the risk of cardiovascular complications increases several fold.

In order for the therapy to be most effective, all patients, without exception, are recommended to undergo regular examinations and take a complex of tests.

Unfortunately, it is not possible to completely get rid of the disease. However, the use of medications can translate the disease into a stage of remission, which enables patients to enjoy normal life, not to experience discomfort and not to recall a problem such as Takayasu's disease. Photos of patients clearly prove this statement.

The success of therapy largely depends on the activity of the pathological process and the presence of complications. In addition, the earlier the correct diagnosis is made, the more optimistic the forecast will be. If you believe the experts, then it is possible and necessary to fight this disease.