How is Takayasu's disease treated?
Last reviewed: 23.04.2024
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Indications for admission to hospital Takayasu
Indications for hospitalization: debut, exacerbation of the disease, examination to determine the protocol of treatment in remission, the need for surgical intervention.
Indications for consultation of other specialists
- Neuropathologist, ophthalmologist - a high level of arterial pressure, cerebrovascular syndrome.
- The phthisiatrician is a tubing patient with a nonspecific aortoarteriitis.
- The surgeon is a pronounced abdominal syndrome. The decision of a question of necessity of operative treatment.
- ENT, dentist - pathology of ENT organs, necessity of teeth sanitation.
Non-drug treatment of Takayasu's disease
In the acute period of Takayasu's disease, hospitalization, bed rest, diet No. 5 are mandatory.
Drug treatment of Takayasu disease
[Pathogenetic treatment
In the acute phase, average doses of prednisolone (1 mg / kg / day with a decrease in dose 1-2 months to the maintenance dose) and methotrexate (not less than 10 mg / m 2 once a week) are prescribed . The maximum dose of prednisolone is given before the disappearance of clinical and laboratory signs of the activity of the process, after which it is slowly reduced to maintenance (10-15 mg / day). In the chronic phase of nonspecific aortoarteritis, the patient receives maintenance doses of prednisolone and methotrexate (usually at the initial dose), in the absence of activity of the process for 1-2 years, therapy is canceled.
Symptomatic treatment
According to the indications, prescribe courses of treatment with drugs that improve collateral circulation (pentoxifylline, dipyridamole, etc.). Patients with hypertension undergo antihypertensive therapy. In the case of antiphospholipid syndrome, anticoagulants are prescribed in the acute phase, followed by a transition to warfarin or acetylsalicylic acid.
Surgical treatment of Takayasu's disease
According to indications (single aortic aortic aneurysm, stratification of aneurysm, high blood pressure and unilateral stenosis of the renal artery), surgery is performed: prosthetics, shunting, endarterectomy and others.
Prognosis for Takayasu's disease
Most patients who have transferred the acute phase of nonspecific aortoarteritis or several exacerbations remain for a long time able-bodied.
The prognosis is generally favorable, the life expectancy of patients is decades. The prognosis is more serious in young children, with the prevalent lesion of the aorta and its branches and the chronic recurrent course of the disease, with renal artery disease and arterial hypertension. Mortality is minimal. The cause of death in severe cases of Takayasu's illness may be: circulatory failure, rupture of the aortic aneurysm, cerebral hemorrhage, chronic renal failure.