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Takayasu arteritis

Last reviewed: 1 Apr 2025
Last updated: 10 Jan 2025

Summary

Definition

History and exam

Key diagnostic factors

  • upper or lower limb claudication
  • absent pulse(s)
  • unequal blood pressures
  • vascular bruits
  • low-grade fever
Full details

Other diagnostic factors

  • transient ischemic attack (TIA)
  • myalgia
  • arthralgia
  • weight loss
  • fatigue
  • dizziness on upper-limb exertion
  • hypertension
  • stroke
  • chest pain
  • abdominal pain
  • diarrhea
  • shortness of breath
  • hemoptysis
  • night sweats
  • vertigo
  • syncope
  • headache
  • heart murmur
  • visual symptoms
  • erythema nodosum
  • pyoderma gangrenosum
Full details

Risk factors

  • genetic predisposition
  • female sex
  • age <40 years
  • Asian ethnicity
Full details

Diagnostic tests

1st tests to order

  • CRP
  • erythrocyte sedimentation rate (ESR)
  • computed tomography angiography (CTA)
  • magnetic resonance angiography (MRA)
Full details

Tests to consider

  • Doppler ultrasound
  • positron emission tomography with radiolabeled fluorodeoxyglucose (PET-FDG)
Full details

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Kenneth J. Warrington, MD
Kenneth J. Warrington

Professor of Medicine

Mayo Clinic College of Medicine

Rochester

MN

Disclosures

KJW declares that he has received clinical trial support from Eli Lilly, BMS, and Kiniksa. He has received consulting fees and honoraria from Amgen and Sanofi. KJW is an author of a number of references cited in this topic.

Acknowledgements

Dr Kenneth J. Warrington would like to gratefully acknowledge Dr Steven R. Ytterberg and Dr Eric L. Matteson, previous contributors to this topic.

Disclosures

SRY declares that he was a sub-awardee of a grant from the US Food and Drug Administration for a pilot study of abatacept, a treatment for Takayasu arteritis. SRY is also a member of the steering committee at the Vasculitis Clinical Research Committee. ELM declares that he has no competing interests.

Peer reviewers

Loic P. Guillevin, MD

Internal Medicine

Hopital Cochin-Paris University

St-Jacques

Paris

France

Disclosures

LPG declares that he has no competing interests.

Gene G. Hunder, MD

Department of Medicine

Division of Rheumatology

Mayo Clinic

Rochester

MN

Disclosures

GGH is an author of a reference cited in this topic. GGH declares that he has no other competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Weyand CM, Goronzy JJ. Medium- and large-vessel vasculitis. N Engl J Med. 2003 Jul 10;349(2):160-9. Abstract

Kerr GS. Takayasu's arteritis. Rheum Dis Clin North Am. 1995 Nov;21(4):1041-58. Abstract

Maz M, Chung SA, Abril A, et al. 2021 American College of Rheumatology/Vasculitis Foundation guideline for the management of giant cell arteritis and Takayasu arteritis. Arthritis Rheumatol. 2021 Aug;73(8):1349-65.Full text  Abstract

Pugh D, Karabayas M, Basu N, et al. Large-vessel vasculitis. Nat Rev Dis Primers. 2022 Jan 6;7(1):93.Full text  Abstract

Isselbacher EM, Preventza O, et al. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022 Dec 13;80(24):e223-393. Abstract

Grayson PC, Ponte C, Suppiah R, et al. 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis. Ann Rheum Dis. 2022 Dec;81(12):1654-60.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Takayasu arteritis images
  • Differentials

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  • Guidelines

    • 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis
    • 2022 ACC/AHA guideline for the diagnosis and management of aortic disease: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines
    More Guidelines
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