Takayasu Arteritis: Consideration of Pulmonary Involvement

Abstract

Takayasu arteritis, a non-specific inflammatory disease affecting the walls of medium and large arteries, is categorized as a medium- and large-vessel vasculitis.1) This disease, which is commonly seen in the Japanese population, was first reported by Professor Mikito Takayasu in 1908, as a case of peculiar change of the central retinal artery with coronary anastomosis and arteriovenous shunt. At the time, Dr. Takayasu was the Director of Kanazawa Medical College Hospital, and it is amazing that, in the discussion of his presentation, the absence of arterial pulse at the radial artery was already mentioned as an associated finding.2) With the accumulation of experience and knowledge, it was documented that this disease involved mainly the aorta and its branches. Because a steno-occlusive lesion of the cervical branches causes a loss of pulse at the upper extremity, the name “pulseless disease” was proposed by Shimizu and Sano in 1951.3) On the other hand, Ross and McKusick suggested the name “aortic arch syndrome” because they thought the pathology was limited to the aortic arch.4) Considering that pulseless disease and aortic arch lesion or atypical co-arctation of the aorta all were attributed to one entity, Ueda et al. introduced the name (pan)-aortitis syndrome in 1965.5) This designation was the standard expression of the disease entity until recently, when there has been a change in the use of the name, mainly because the name “aortitis syndrome” has not been well accepted in the Western literature. The designation “Takayasu arteritis” has become the standard in Japan and elsewhere in appreciation of the original contribution of Professor Takayasu. Historically in Japan, two groups, the Tokyo University group and the Tokyo Medical and Dental University group6, 7) have played leading roles in the investigation of this disease entity. In particular, the former group has accomplished fruitful results in regard to the surgical treatment of this interesting lesion.8–10)