Takayasu's arteritis: An uncommon cause of renal artery stenosis and therapeutic considerations

Sharad Virmani, Luis Ortega, Loay Salman, Tushar Vachharajani, Arif Asif, Ali Nayer

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)14-19
Number of pages6
JournalOpen Urology and Nephrology Journal
Volume6
Issue number1
DOIs
StatePublished - Dec 1 2012

Keywords

  • Anti-TNFa
  • Immunosuppression
  • Percutaneous transluminal angioplasty
  • Reconstructive surgery
  • Renal artery stenosis
  • Revascularization
  • Takayasu's arteritis
  • Vasculitis

ASJC Scopus subject areas

  • Nephrology
  • Urology

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