TAKAYASU ARTERITIS MAY BE UNDERDIAGNOSED IN NORTH-AMERICA

OBJECTIVES: To summarize some of the literature about Takayasu arterit is, a nonspecific chronic inflammatory disease involving the aorta and its main branches, and to analyze the criteria for its diagnosis. The pulmonary artery and its branches, as well as the coronary arteries, may also be involved. DATA ANALYSIS: Although Takayasu arteritis; has been commonly reported in Asian countries such as Japan, India, China and Korea, case reports from other parts of the world describing;sympt oms of this disease are also available. Because : of nonspecific patho logy, a rather nonspecific initial clinical presentation and an obliga tory criterion of age (40 years or younger) it is possible that the di sease may be underdiagnosed in Europe and North America. The cause of this disease _ remains obscure. Various infections have been blamed bu t genetic and immunological disturbances seem to play a major role in, bringing Takayasu arteritis into the list of autoimmune diseases. INT ERVENTIONS: Takayasu arteritis responds well to glucocorticoids/cyclop hosphamide in the acute (prepulseless) phase. In the chronic fibrotic phase, treatmeat of hypertension and various angioplastic and surgical interventions are CONCLUSIONS: Adoption of improved diagnostic criter ia may change the prevailing view that Takayasu arteritis is an Asian disease. Understanding of the pathogenesis at cellular and molecular l evels is needed. Creation of an animal model would be a desirable tool in that direction.