Takayasu's Arteritis

Expert Takayasu's Arteritis treatment in Bhopal. Dr. Prateek Deo manages large vessel vasculitis to prevent vascular occlusion, stroke, and organ damage.

What is Takayasu's Arteritis?

Takayasu's Arteritis (TAK) is a rare, chronic, granulomatous, large-vessel vasculitis that primarily affects the aorta and its major branches, as well as the pulmonary arteries. Named after Dr. Mikito Takayasu, who first described the characteristic eye findings in 1908, TAK is characterised by vessel wall inflammation that leads to stenosis (narrowing), occlusion (blockage), or aneurysmal dilatation of large blood vessels, cutting off blood supply to vital organs.

TAK is particularly prevalent in Asia, with India having one of the highest incidences globally. It predominantly affects young women, typically between 15-40 years of age — giving it the historical moniker "Pulseless Disease" due to loss of peripheral pulses from subclavian artery stenosis.

Angiogram showing Takayasu's

MR Angiography showing severe stenosis of subclavian arteries — a hallmark vascular finding in Takayasu's Arteritis.

Two Phases: Pre-Pulseless and Pulseless

TAK typically progresses through two clinical phases:

Phase 1 (Systemic/Pre-Pulseless Phase)

The early, inflammatory phase is dominated by non-specific systemic symptoms that are easily mistaken for other conditions:

  • Fever, night sweats, weight loss, and profound fatigue.
  • Elevated ESR, CRP, and anaemia of chronic inflammation.
  • Myalgias (muscle aches) and arthralgias.
  • Skin nodules (erythema nodosum).

Phase 2 (Occlusive/Pulseless Phase)

As vessel wall inflammation leads to fibrosis and stenosis:

  • Absent or diminished pulses in the arms or legs.
  • Blood pressure discrepancy (>10 mmHg) between arms — a critical examination finding.
  • Arm claudication — pain/weakness in the arms with activity.
  • Renovascular hypertension — severe, difficult-to-control hypertension from renal artery stenosis.
  • Carotidynia — tenderness over the carotid arteries.
  • Stroke, visual loss, or TIA from carotid/vertebral involvement.
  • Angina or heart failure from aortic valve regurgitation or coronary artery involvement.
Young woman with hypertension

Young women with unexplained severe hypertension or blood pressure discrepancy between arms should be urgently evaluated for Takayasu's Arteritis.

⚠️ Think TAK in Young Women with Hypertension

Takayasu's Arteritis is a leading cause of renovascular hypertension in young women in India. Any woman under 40 years presenting with severe, difficult-to-control hypertension should be evaluated for renal artery stenosis secondary to TAK before initiating lifelong antihypertensive therapy.

Dr. Prateek's Approach to Takayasu's Arteritis

TAK requires a Rheumatologist who can recognise the disease in its early, systemic phase and initiate aggressive treatment before irreversible vascular damage occurs. Dr. Prateek Deo's experience with complex vasculitis from PGIMER equips him uniquely to manage this challenging condition.

Advanced Imaging

MR Angiography and FDG-PET/CT to assess vessel wall inflammation and stenosis extent — guiding both medical and surgical management decisions.

Immunosuppression

High-dose Prednisolone as initial therapy, with early introduction of Methotrexate, Azathioprine, or Rituximab/Tocilizumab for steroid-sparing remission maintenance.

Vascular Team Approach

Coordination with vascular surgery for revascularisation of critical stenoses — timed correctly during disease remission to optimise outcomes.

BP Monitoring

Careful blood pressure measurement in all limbs to detect new stenoses, and management of renovascular hypertension to protect the kidneys.