What is Takayasu Arteritis?
Takayasu arteritis is inflammation of the aorta and its major branches, narrowing them over time. It causes arm or leg tiredness with activity, weak or absent pulses, unequal blood pressure between the arms, and often high blood pressure from narrowing of the kidney arteries. It typically affects young women and is relatively more common in India than in Western countries.
Also called: Pulseless disease, aortoarteritis
Who gets Takayasu Arteritis?
Usually women under 40, and it is markedly more common in Asian populations — India, Japan and South-East Asia — than in Europe or North America. Symptoms often begin in the teens or twenties. Because early symptoms are vague, the diagnosis is frequently made only when a pulse is found to be absent or blood pressure differs between the arms.
What are the symptoms of Takayasu Arteritis?
Not everyone has every symptom below, and having one does not confirm the diagnosis. These are the features that most often lead to assessment:
- Fatigue, low-grade fever, weight loss and generalised aching in the early phase
- Arm or leg tiredness, aching or cramping with use, easing with rest
- Weak or absent pulses in one or both arms
- Blood pressure that differs significantly between the two arms
- High blood pressure, particularly in a young person
- Dizziness, fainting or visual disturbance on standing or turning the head
- Pain over the neck or along an artery
- Chest or back pain
- Stroke or transient ischaemic attack in advanced disease
How is Takayasu Arteritis diagnosed?
The examination is central: pulses in all four limbs, blood pressure in both arms, and listening for bruits over the neck, chest and abdomen.
Inflammatory markers are usually raised in the active phase but can be normal despite ongoing vessel damage, which makes imaging essential rather than optional.
CT or MR angiography of the aorta and its branches shows the extent of narrowing, wall thickening and any aneurysm. PET-CT identifies active inflammation and is useful when markers and imaging disagree.
Other causes of large-vessel disease, including tuberculosis-related aortitis — an important consideration in India — are excluded.
How is Takayasu Arteritis treated?
Corticosteroids control inflammation initially, combined from the outset with a steroid-sparing agent — methotrexate, azathioprine or mycophenolate — because relapse on steroid reduction is the rule rather than the exception.
Biologics, particularly tocilizumab and TNF inhibitors, are used in refractory or relapsing disease.
Blood pressure control is critical and technically difficult: readings must be taken in the arm with the least arterial narrowing, or they will mislead.
Angioplasty or bypass surgery is considered for critical narrowing, and is best performed when inflammation is quiescent, since intervening during active disease has a higher failure rate.
Living with Takayasu Arteritis
This is a long-term condition needing regular imaging as well as blood tests, because damage can progress even when inflammatory markers are normal. Cardiovascular risk management, careful blood pressure monitoring in the correct arm, and planning around pregnancy — which is usually possible with stable disease — form the core of ongoing care.
When should you see a rheumatologist?
A young adult with unexplained high blood pressure, arm or leg fatigue on exertion, a weak pulse, or a difference in blood pressure between the arms should be assessed for large-vessel vasculitis.
Common questions about Takayasu Arteritis
Why is my blood pressure different in each arm?
Because narrowing of the artery to one arm gives a falsely low reading on that side. Once identified, blood pressure is always measured in the less affected arm, otherwise treatment can be based on a misleading number.
Can Takayasu arteritis be cured?
It is controlled rather than cured. Most patients need long-term immunosuppression, and relapse when treatment is reduced too quickly is common. Damage already done to a vessel does not reverse, which is why early control matters.
Will I need surgery?
Only some patients. Angioplasty or bypass is considered for critical narrowing causing symptoms, and is best done when the inflammation is quiet — operating during active disease has a much higher failure rate.
Can I get pregnant with Takayasu arteritis?
Usually yes, with planning. Pregnancy is best undertaken during stable disease, on pregnancy-compatible medicines, with blood pressure monitored closely and shared care with an obstetric team.
This page is general information to support a consultation. It is not a diagnosis, and it does not replace an assessment by a doctor who has examined you.