Aortic arch/Takayasu arteritis (TA)/Pulseless disease:
• more common in Japan and Mexico (rare in Europe and North America)
• usually young woman (average 10-30yrs) presenting with prolonged period of malaise, fever and weight loss
• later develop vascular headache, visual symptoms and upper extremity claudication. May have CVA
• 50% have arthralgias
• due to inflammation and granulomatous necrotising arteritis of aorta ischaemia.
• American College of Rheumatology criteria for diagnosis is when 3 of 6 criteria are present (age of onset <40 years; claudication of extremities; decreased brachial pulse; blood pressure difference between arms of > 10mmHG; bruit over subclavian arteries or aorta; abnormality on arteriogram)
• corticosteroids are effective in early stages. Later may need anticoagulants or vascular surgery
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