小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 上肢或下肢疼痛或不适
- 脉搏消失
- （双侧肢体）血压不等
- 血管杂音
- 低热
其他诊断因素
- 短暂性缺血发作 (TIA)
- 肌痛
- 关节痛
- 体重减轻
- 疲劳
- 上肢用力时眩晕
- 高血压
- 卒中
- 胸痛
- 腹痛
- 腹泻
- 呼吸短促
- 咯血
- 盗汗
- 眩晕
- 晕厥
- 头痛
- 心脏杂音
- 视觉症状
- 结节性红斑
- 坏疽性脓皮病
危险因素
- 遗传易感性
- 女性
- 年龄＜40 岁
- 亚裔
诊断性检查
首要检查
- 红细胞沉降率 (ESR)
- C 反应蛋白 (CRP)
- CT 血管造影 (CTA)
- 磁共振血管成像 (MRA)
需考虑的检查
- 多普勒超声
- 放射性同位素示踪的氟脱氧葡萄糖正电子发射断层成像 (PET-FDG)
治疗流程
所有患者
撰稿人
作者
Kenneth J. Warrington, MD
Professor of Medicine
Mayo Clinic College of Medicine
Rochester
MN
利益声明
KJW declares that he has received clinical trial support from Eli Lilly, GSK, and Kiniksa. He has received consulting fees and honoraria from Chemocentryx. KJW is an author of a number of references cited in this topic.
鸣谢
Dr Kenneth J. Warrington would like to gratefully acknowledge Dr Steven R. Ytterberg and Dr Eric L. Matteson, previous contributors to this topic.
利益声明
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's arteritis. SRY is also a member of the steering committee at the Vasculitis Clinical Research Committee. ELM declares that he has no competing interests.
同行评议者
Loic P. Guillevin, MD
Internal Medicine
Hopital Cochin-Paris University
St-Jacques
Paris
France
利益声明
LPG declares that he has no competing interests.
Gene G. Hunder, MD
Department of Medicine
Division of Rheumatology
Mayo Clinic
Rochester
MN
利益声明
GGH is an author of a reference cited in this topic. GGH declares that he has no other competing interests.
鉴别诊断
- 巨细胞动脉炎 (GCA)
- 原发性高血压
- 梅毒
更多 鉴别诊断指南
- 2022 年版美国风湿病学会/EULAR 大动脉炎分类标准
- 巨细胞动脉炎和大动脉炎管理指南
更多 指南
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