What is the role of lab testing in the workup of Takayasu arteritis?

Updated: Nov 14, 2018
  • Author: Jefferson R Roberts, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Laboratory test results in individuals with Takayasu arteritis tend to be nonspecific. The erythrocyte sedimentation rate may be high, generally greater than 50 mm/h, in early disease but normal later. Leukocyte count may be normal or slightly elevated. A moderate, normochromic anemia may be present in individuals with active disease. [16, 22]

Autoantibodies observed in other connective tissue diseases, including rheumatoid factor, antinuclear antibodies, anticardiolipin antibodies, and antineutrophil cytoplasmic antibodies (ANCA), are as common as in the general population. Circulating antiendothelial antibodies may be present in high titers. This finding is considered nonspecific, because it is reported sporadically and may be present in other connective tissue diseases and in angiitis obliterans. Antiaorta antibodies may be present, but testing for them seldom is performed, if ever.

Some researchers found that the levels of soluble vascular cell adhesion molecule–1 (VCAM-1) were significantly higher in patients with Takayasu arteritis compared with normal, healthy controls and that they were also significantly higher in older patients than in younger ones, suggesting that VCAM-1 may serve as a marker of disease activity and progression with age. Tripathy et al reported that cell adhesion molecule levels remain elevated in patients with inactive Takayasu arteritis. [32]

Hypoalbuminemia and increased levels of fibrinogen, alpha2-globulin, and gamma globulin are common. Urinalysis may be consistent with nephrotic syndrome.

HLA typing is not a standard diagnostic procedure for North American patients. Presumably, a finding of HLA-B*52 in such patients reinforces the diagnosis; it is not a definite diagnostic tool.


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