The Takayasu

The Takayasu - inflammation of the walls of the artery. The Takayasu can be local, for example purulent Takayasu when the abscess, osteomyelitis, and to have common, such as when sepsis, rheumatism and other infectious and infectious-allergic diseases. There are diseases in which the Takayasu is the main primary painful process: endarteriit (see), nodosa nadasny (see), as temporal arteritis diagnostics.
Cm. also Vasculitis.

syphilitic masorti
Fig. 6. Syphilitic masorti (painting oreina); break elastic fibers the walls of the aorta.

Arteritis - inflammation of the arterial wall different origin, different morphology, different trends and clinical significance. The histological diagnosis of Takayasu" needs to be supplemented by characterizing its qualitative characteristics. Used sometimes in clinical diagnosis of coronary insufficiency, the term "coronary" (literally - inflammation of the coronary arteries) is valid morphological content of the disease and has no rational sense, because usually we are talking about the atherosclerotic process. The same applies to the term "aortic"; the real form of the disease - syphilitic masorti and occasionally encountered in protracted septic endocarditis Antartic (endaortitis lenta).
In accordance with generally accepted taxonomy of inflammatory processes distinguish the following types of arteritis: in the form of inflammation - on advantage alterative, exudative, mostly productive; preferential localization in the vascular wall - endarteriit (inner layer), mesenteric (average muscle layer), nodosa (adventitia and the immediate circle of the vessel), panarteritis (coverage inflammation of all layers of the vascular wall); the over - sharp, chronic. Different types of arteritis can affect the blood vessels of different caliber.
The advantage alterative the Takayasu most often found in the form fibrinoidnogo swelling or fibrinoidnogo necrosis of the vessel wall, and the inclusion of this form to the group of inflammatory processes is controversial. With a loss of structure arterial wall, segmental, or complete its transformation into an unstructured fine-grained mass similar to fibrin (see Fibrinogene transformation). Found this form of Takayasu direct effect on arterial wall highly active substances (some toxic substances, hydrochloric acid gastric juice ulcers and erosions of the mucous membrane of the stomach and others). Characteristic is also fibrinoidnogo the transformation of the walls of arteries in the fibers of the placenta and the mucous membrane of the uterus during pregnancy. More often than not, fibrinoidnogo the transformation of the artery walls is an indicator giperergicakie reaction.
The advantage of exudative Takayasu most often found in the form of purulent inflammation and spread over the arterial wall of the surrounding tissue (cellulitis, purulent osteomyelitis and others). Thus the artery wall is pierced by the white blood cells, the structure of layers is erased. It may exit purulent meltdown artery erozionnyy bleeding and death (for example, when the abscess neck). Similar to this pattern of change is the basis of pulmonary hemorrhage at a tuberculosis of lungs. In this case, exudative inflammation complemented caseous necrosis of the arterial wall and exudation and the development of acute aneurysm.
Described inflammation of the arteries are acute. Most often the Takayasu has a chronic character and form of productive inflammation. The latter usually is not specific and is developing in the inner layer (see Endarteritis). In some varieties of Takayasu meets the combination of alternative and proliferative processes in a certain sequence, characteristic of allergic inflammation. Such A. sometimes develop in pockets and on the periphery of chronic inflammatory and ulcerous processes of a various origin (tuberculosis, syphilis, chronic ulcer of the stomach and so on). Especially characterized by a combination of alternative and productive processes at the knotty nodosa (see Nodosa nadasny). The rule is the development of productive endarteritis in the membranes of the brain in tuberculous meningitis, especially with stretched over (under the influence of antibiotics). In the basis of the classical forms of Takayasu's arteritis ("sickness absence pulse") lies alterative-productive panarteritis shoulder or subclavian artery. When Takayasu specific etiology (tuberculosis), developing hematogenous route or through a transition process on the wall of the artery from surrounding tissues, granulation inflammation complemented by the development of specific TB granulomas.
A special kind of Takayasu is the so-called giant cell arteritis diagnostics with the availability of multi-core giant cells among inflammatory proliferate arterial wall. Usually it is panarteritis leading to the obliteration of the lumen of the artery.
The nature of the process is unclear, most likely allergic origin. Important clinical form of such Takayasu is the so-called temporal arteritis diagnostics (see), leading to the obliteration of the temporal artery with appropriate neurological symptoms.
Clinical manifestations A. vary greatly and depend on the characteristics of the process, the caliber of the affected vessel, the pace of development of the process and its outcome. In chronic forms of productive inflammation, as a rule, a narrowing of the lumen until the complete obliteration. Cm. also Vasculitis.