Complications
Many of the complications of Takayasu arteritis represent ischemic symptoms related to the development of vascular stenoses and occlusions. Differentiating between ischemia resulting from active vasculitis and ischemia from vascular damage can be difficult. Regular vascular imaging studies can help with follow-up but should also be obtained in the setting of new ischemic symptoms. Attempts to control vascular inflammation are needed to try to minimize long-term vascular damage.
Hypertension is a common complication, usually due to renal artery or aortic valve stenosis.[8]
Long-term glucocorticoid therapy increases the risk of osteoporosis, and the greatest amount of bone loss occurs in the first 6 to 12 months of therapy. Risk is proportional to cumulative dose, so glucocorticoid dose should be reduced as soon as possible.
Long-term glucocorticoid therapy can cause the development of diabetes mellitus. A high degree of vigilance is required.
Patients require influenza and pneumococcal immunizations annually. Use of prophylactic antibiotic therapy to prevent Pneumocystis jirovecii pneumonia is important, especially when the prednisone dose is more than 20 mg daily.
Most often involves the ascending thoracic aorta.
Congestive heart failure occurs in about 25% of patients.[8]
Angina from coronary artery involvement is described in up to 10% of patients.[8]
Involvement of carotid or vertebral arteries can result in a transient ischemic attack or stroke. Visual disturbance including blurred vision and amaurosis fugax may be present, but permanent visual loss is uncommon.[8]
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