TY - JOUR
T1 - Takayasu's arteritis
T2 - An uncommon cause of renal artery stenosis and therapeutic considerations
AU - Virmani, Sharad
AU - Ortega, Luis
AU - Salman, Loay
AU - Vachharajani, Tushar
AU - Asif, Arif
AU - Nayer, Ali
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012
Y1 - 2012
N2 - Takayasu's arteritis is a rare disorder characterized by granulomatous and necro-inflammatory disease of the aorta and its major branches. Its etiology remains unknown. We report a young woman with Takayasu's arteritis affecting the aortic arch, carotid, mesenteric, celiac and bilateral renal arteries resulting in severe hypertension, unilateral renal atrophy and renal insufficiency. The immunosuppressive therapy did not halt the progression of her vascular disease, which required revascularization procedures on numerous occasions. Here, the clinical manifestations and histopathological features of Takayasu's arteritis are reviewed. In addition, the available medical treatment options including glucocorticoids, cytotoxic agents and TNF-alpha inhibitors are discussed. Furthermore, current revascularization procedures such as percutaneous transluminal angioplasty and reconstructive vascular surgery in the treatment of occlusive vasculopathy due to Takayasu's arteritis are discussed. Although the prognosis of this debilitating disease has improved over the past two decades, a better understanding of its etiology and pathogenesis will facilitate the discovery of effective target-specific treatment strategies with a narrow adverse effects profile.
AB - Takayasu's arteritis is a rare disorder characterized by granulomatous and necro-inflammatory disease of the aorta and its major branches. Its etiology remains unknown. We report a young woman with Takayasu's arteritis affecting the aortic arch, carotid, mesenteric, celiac and bilateral renal arteries resulting in severe hypertension, unilateral renal atrophy and renal insufficiency. The immunosuppressive therapy did not halt the progression of her vascular disease, which required revascularization procedures on numerous occasions. Here, the clinical manifestations and histopathological features of Takayasu's arteritis are reviewed. In addition, the available medical treatment options including glucocorticoids, cytotoxic agents and TNF-alpha inhibitors are discussed. Furthermore, current revascularization procedures such as percutaneous transluminal angioplasty and reconstructive vascular surgery in the treatment of occlusive vasculopathy due to Takayasu's arteritis are discussed. Although the prognosis of this debilitating disease has improved over the past two decades, a better understanding of its etiology and pathogenesis will facilitate the discovery of effective target-specific treatment strategies with a narrow adverse effects profile.
KW - Anti-TNFa
KW - Immunosuppression
KW - Percutaneous transluminal angioplasty
KW - Reconstructive surgery
KW - Renal artery stenosis
KW - Revascularization
KW - Takayasu's arteritis
KW - Vasculitis
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U2 - 10.2174/1874303X01306010014
DO - 10.2174/1874303X01306010014
M3 - Article
AN - SCOPUS:84876092955
VL - 6
SP - 14
EP - 19
JO - Open Urology and Nephrology Journal
JF - Open Urology and Nephrology Journal
SN - 1874-303X
IS - 1
ER -