29th January 2024

Diagnosis

Blood tests demonstrating raised inflammatory markers, primarily a high ESR is indicative of disease. Angiography is the gold standard for diagnosis, which detects vascular stenosis in the large arteries. Biopsy of the affected vessel will demonstrate granulomatous thickening of the aortic arch, plasma cells and lymphocytes in media and adventitia and vascular fibrosis. These findings are indistinguishable with giant cell arteritis. 

The diagnosis of Takayasu’s arteritis requires three or more of the following criteria to be fulfilled: 

• Age of onset: ≤ 40 years
• Claudication of upper or lower extremities while in use
• Audible bruit over the subclavian artery or abdominal aorta
• Decreased brachial artery pulse
• Blood pressure difference > 10 mm Hg between arms
• Abnormal arteriography of the aorta or large blood vessels in the extremities that is not due to arteriosclerosis or fibromuscular dysplasia

Image Source: Wikipedia (2021). Takayasu’s_arteritis, Licensed under a creative commons licence. Available for free at:  https://en.wikipedia.org/wiki/Takayasu%27s_arteritis (Accessed: 16 February 2022).