Arterite di Takayasu: malattia “senza polso”
Table of Contents
Definizione
L’arterite di Takayasu è un arterite giganto-cellulare che colpisce l’aorta e i suoi rami principali:le arterie coronarie e le arterie polomonari.
Eziologia: ignota
Anatomia patologica
Infiammazione di tutti gli strati basali (panarterite), infiltrazione linfocitaria e di cellule giganti multinucleate. Il processo infiammatorio è seguito da una reazione fibrosa e stenosante. La topografia della lesione è variabile: aorta, sede del tronco brachiocefalico, arterie cerebrali, renali e polmonari. Esistono forme di transizione fra arterite temporale e malattia di Takayasu.
Sintomi
L’arterite di Takayasu è rara; descritta dapprima in Oriente è stata osservata in tutto il mondo, ad ammalarsi sono più spesso donne giovani, tra i 20 e i 30 anni.
Segni generali:
- Astenia
- Dimagrimento
- Temperatura subfebbrile
Segni cardiovascolari:
- Diminuzione o assenza del polso radiale;
- Soffio sistolico e diastolico sul focolaio aortico;
- Angor
- Claudicatio intermittens
- Ipertensione arteriosa
- Scompenso cardiaco
Segni neurologici:
- Accidenti vascolari cerebrali
- Epilessia
- Disturbi visivi e cecità.
Esami di laboratorio
Esami di laboratorio e altri esami speciali: leucocitosi, velocità di sedimentazione aumentata. La diagnosi si basa sull’angiografia aortica e la biopsia di un’arteria colpita.
Diagnosi
L’arterite di Takayasu: deve essere distinta dalle occlusioni ateromatose dell’arco aortico, il cui trattamento è chirurgico.
Prognosi
La sopravvivenza a 5 anni dopo la diagnosi è rara; sono state descritte remissioni spontanee.
Terapia
La cura si basa sull’impiego di farmaci corticosteroidi, di solito prednisolone, cui può essere aggiunto un farmaco immunosoppressore in caso di mancata risposta.
Ti potrebbero interessare:
- Stenosi aortica
- Porpora di Shöenlein-Henoch
- Sindrome di Goodpasture
- Arterite di Takayasu: gli effetti benefici dell’esercizio fisico
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