Suggest treatment for takayasu disease with severe pain in the neck
Patient: Hi doctor, i have diagonsed with Takayasu Disease 6 months ago.. I have severe pain running down from my neck to my left arm... I have difficulties raising my arm up for 1 miniute... The pain is unbearable.. I cant carry or shampooing my hair, small things are difficult to do... I am very devastrated as i am only 29 and not married.. My future is a question mark in my life.. I was given presodine every 6 hours for two days when i was hospitalised.. But once im discharged i stopped my steriods of 20mg as the side affects are scarry.. Im already suffering, and i dont wish to suffer with other diseases cause by this drug.. Please advise me on how to be cured without steriods.. and what wat happens if it not treated or got worse. Thank you Selvi Doctor: Hi,  Takayasu’s arteritis is progressive, and there is no definitive therapy.  Glucocorticoids and immunosuppressive agents are effective in some patients during the acute phase but have the risk of side effects as you have experienced with prednisolone...  Surgical bypass or endovascular intervention of a critically stenotic artery may be necessary. What you are having is some large artery occlusion in the upper limb, causing ischemic/claudication pain on active movement of the limb.   Angiography is needed to delineate focal or segmental changes/occlusion in large arteries in the upper extremities. Synthetic or autogenous bypass grafts need to be placed onto disease-free segments of vessels.  For focal lesions, there have been reports of success with angioplasty and may provide relief.  Hope I have answered your query. Let me know if I can assist you further.   Regards, Dr. Tushar Kanti Biswas,  Internal Medicine Specialist