(CRP) may provide additional support for the presence of a systemic inflammatory process; however, normal values of ESR or CRP should not markedly deter making the diagnosis of TAK. (See 'Our approach' above and 'Laboratory findings' above.) Imaging Imaging studies are essential for establishing the diagnosis of TAK and for determining the extent of vascular involvement. Patients with suspected TAK should undergo imaging of the arterial tree by magnetic resonance angiography (MRA) or CT angiography (CTA) to evaluate the arterial lumen. In general, we favor using MRA to evaluate for TAK, since it avoids the radiation exposure and risks of iodinated contrast of CTA; similarly, if periodic repeat studies are anticipated, MRA is again the preferred choice. Imaging of the arterial tree of the chest, abdomen, head and neck, or other areas by MRA or CTA demonstrates smoothly tapered luminal narrowing or occlusion ( image 1) that is sometimes accompanied by thickening of the wall of the vessel ( image 2A-B). There is an increasing use of positron emission tomography (PET), often in combination with CT (PET- CT) or MR (PET-MR) to aid in the diagnosis of TAK, but there is less consensus on this test's usefulness as a measure of disease activity, and its role remains under study. (See 'Imaging' above.) Differential diagnosis Conditions that should be considered in the differential diagnosis of TAK include giant cell (temporal) arteritis (GCA), IgG4-related disease, Beh et syndrome, infectious aortitis, fibromuscular dysplasia, atherosclerosis, genetic causes of aneurysms such as Ehlers-Danlos syndrome, and other diseases which can feature large-vessel vasculitis/aortitis such as Cogan syndrome, relapsing polychondritis, and spondyloarthropathies. (See 'Differential diagnosis' above.) https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 12/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate ACKNOWLEDGMENT The editorial staff at UpToDate acknowledge Gene Hunder, MD, who contributed to an earlier version of this topic review. Use of UpToDate is subject to the Terms of Use. REFERENCES 1. Lupi-Herrera E, S nchez-Torres G, Marcushamer J, et al. Takayasu's arteritis. Clinical study of 107 cases. 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Terao C, Yoshifuji H, Matsumura T, et al. Genetic determinants and an epistasis of LILRA3 and HLA-B*52 in Takayasu arteritis. Proc Natl Acad Sci U S A 2018; 115:13045. 10. Seko Y, Minota S, Kawasaki A, et al. Perforin-secreting killer cell infiltration and expression of a 65-kD heat-shock protein in aortic tissue of patients with Takayasu's arteritis. J Clin Invest 1994; 93:750. 11. Seko Y, Sato O, Takagi A, et al. Restricted usage of T-cell receptor Valpha-Vbeta genes in infiltrating cells in aortic tissue of patients with Takayasu's arteritis. Circulation 1996; 93:1788. 12. Le Joncour A, Desbois AC, Leroyer AS, et al. Mast cells drive pathologic vascular lesions in Takayasu arteritis. J Allergy Clin Immunol 2022; 149:292. https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 13/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate 13. Cid MC, Font C, Coll-Vinent B, Grau JM. Large vessel vasculitides. Curr Opin Rheumatol 1998; 10:18. 14. Yamada I, Shibuya H, Matsubara O, et al. Pulmonary artery disease in Takayasu's arteritis: angiographic findings. AJR Am J Roentgenol 1992; 159:263. 15. Goel R, Gribbons KB, Carette S, et al. Derivation of an angiographically based classification system in Takayasu's arteritis: an observational study from India and North America. Rheumatology (Oxford) 2020; 59:1118. 16. Sreih AG, Cronin K, Shaw DG, et al. Diagnostic delays in vasculitis and factors associated with time to diagnosis. Orphanet J Rare Dis 2021; 16:184. 17. Mason JC. Takayasu arteritis advances in diagnosis and management. Nat Rev Rheumatol 2010; 6:406. 18. Serra R, Butrico L, Fugetto F, et al. Updates in Pathophysiology, Diagnosis and Management of Takayasu Arteritis. Ann Vasc Surg 2016; 35:210. 19. Rodr guez-Pla A, de Miguel G, L pez-Contreras J, et al. Bilateral blindness in Takayasu's disease. Scand J Rheumatol 1996; 25:394. 20. Nakabayashi K, Kurata N, Nangi N, et al. Pulmonary artery involvement as first manifestation in three cases of Takayasu arteritis. Int J Cardiol 1996; 54 Suppl:S177. 21. Kerr GS, Hallahan CW, Giordano J, et al. Takayasu arteritis. Ann Intern Med 1994; 120:919. 22. Yoneda S, Nukada T, Tada K, et al. Subclavian steal in Takayasu's arteritis. A hemodynamic study by means of ultrasonic Doppler flowmetry. Stroke 1977; 8:264. 23. Grayson PC, Tomasson G, Cuthbertson D, et al. Association of vascular physical examination findings and arteriographic lesions in large vessel vasculitis. J Rheumatol 2012; 39:303. 24. Hata A, Numano F. Magnetic resonance imaging of vascular changes in Takayasu arteritis. Int J Cardiol 1995; 52:45. 25. Yamada I, Numano F, Suzuki S. Takayasu arteritis: evaluation with MR imaging. Radiology 1993; 188:89. 26. Yamada I, Nakagawa T, Himeno Y, et al. Takayasu arteritis: evaluation of the thoracic aorta with CT angiography. Radiology 1998; 209:103. 27. Paul JF, Hernigou A, Lefebvre C, et al. Electron beam CT features of the pulmonary artery in Takayasu's arteritis. AJR Am J Roentgenol 1999; 173:89. 28. Kissin EY, Merkel PA. Diagnostic imaging in Takayasu arteritis. Curr Opin Rheumatol 2004; 16:31. 29. Keenan NG, Mason JC, Maceira A, et al. Integrated cardiac and vascular assessment in https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 14/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate Takayasu arteritis by cardiovascular magnetic resonance. Arthritis Rheum 2009; 60:3501. 30. Grayson PC, Alehashemi S, Bagheri AA, et al. 18 F-Fluorodeoxyglucose-Positron Emission Tomography As an Imaging Biomarker in a Prospective, Longitudinal Cohort of Patients With Large Vessel Vasculitis. Arthritis Rheumatol 2018; 70:439. 31. Fassbender HG. Pathology and pathobiology of rheumatic diseases, Second Edition, Springe r-Verlag, Berlin 2002. p.304. 32. Nasu T. Takayasu's truncoarteritis. Pulseless disease or aortitis syndrome. Acta Pathol Jpn 1982; 32 Suppl 1:117. 33. Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013; 65:1. 34. Jennette JC, Falk RJ, Andrassy K, et al. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum 1994; 37:187. 35. Ishikawa K. Diagnostic approach and proposed criteria for the clinical diagnosis of Takayasu's arteriopathy. J Am Coll Cardiol 1988; 12:964. 36. Sharma BK, Jain S, Suri S, Numano F. Diagnostic criteria for Takayasu arteritis. Int J Cardiol 1996; 54 Suppl:S141. 37. Grayson PC, Ponte C, Suppiah R, et al. 2022 American College of Rheumatology/EULAR Classification Criteria for Takayasu Arteritis. Arthritis Rheumatol 2022; 74:1872. 38. Hunder GG. Giant cell arteritis and polymyalgia rheumatica. Med Clin North Am 1997; 81:195. 39. Michel BA, Arend WP, Hunder GG. Clinical differentiation between giant cell (temporal) arteritis and Takayasu's arteritis. J Rheumatol 1996; 23:106. 40. Grayson PC, Maksimowicz-McKinnon K, Clark TM, et al. Distribution of arterial lesions in Takayasu's arteritis and giant cell arteritis. Ann Rheum Dis 2012; 71:1329. 41. Maksimowicz-McKinnon K, Clark TM, Hoffman GS. Takayasu arteritis and giant cell arteritis: a spectrum within the same disease? Medicine (Baltimore) 2009; 88:221. Topic 8238 Version 27.0 https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 15/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate GRAPHICS Takayasu aortitis on MRI A 33-year-old man with Takayasu aortitis. The MRI shows narrowing of the region of the isthmus (arrowhead) as well as diffuse irregular narrowing of the abdominal aorta (arrow). MRI: magnetic resonance imaging. Graphic 95682 Version 1.0 https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 16/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate Fusiform aneurysm and wall thickening in a patient with Takayasu arteritis Enlargement of the descending thoracic aorta and thickening of the vessel wall (arrows) is apparent in this contrast-enhanced CT scan. These findings suggest an active inflammatory process. CT: computed tomography. Reproduced with permission from: Sueyoshi E, Sakamoto I, Hayashi K. Aortic aneurysms in patients with Takayasu's arteritis: CT evaluation. Am J Roentgenology 2000; 175:1727. Copyright 2000 American Roentgen Ray Society. Graphic 62264 Version 6.0 https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 17/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate Fusiform aneurysm Enlargement of the contrast-filled descending thoracic aneurysm has occurred despite treatment with glucocorticoids. Reproduced with permission from: Sueyoshi E, Sakamoto I, Hayashi K. Aortic aneurysms in patients with Takayasu's arteritis: CT evaluation. Am J Roentgenology 2000; 175:1727. Copyright 2000 American Roentgen Ray Society. Graphic 70960 Version 5.0 https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 18/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate Takayasu aortitis on aortography A 13-year-old female with Takayasu aortitis. The aortogram shows tubular narrowing of the isthmus of the aorta (arrow). Graphic 93976 Version 2.0 https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 19/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate Names for vasculitides adopted by the 2012 International Chapel Hill Consensus Conference on the Nomenclature of Vasculitides Large-vessel vasculitis Takayasu arteritis Giant cell arteritis Medium-vessel vasculitis Polyarteritis nodosa Kawasaki disease Small-vessel vasculitis ANCA-associated vasculitis Microscopic polyangiitis Granulomatosis with polyangiitis (Wegener's) Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) Immune complex small-vessel vasculitis Anti-glomerular basement membrane disease Cryoglobulinemic vasculitis IgA vasculitis (Henoch-Sch nlein) Hypocomplementemic urticarial vasculitis (anti-C1q vasculitis) Variable-vessel vasculitis Beh et's syndrome Cogan's syndrome Single-organ vasculitis Cutaneous leukocytoclastic angiitis Cutaneous arteritis Primary central nervous system vasculitis Isolated aortitis Others Vasculitis associated with systemic disease Lupus vasculitis Rheumatoid vasculitis https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 20/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate Sarcoid vasculitis Others Vasculitis associated with probable etiology Hepatitis C virus-associated cryoglobulinemic vasculitis Hepatitis B virus-associated vasculitis Syphilis-associated aortitis Drug-associated immune complex vasculitis Drug-associated ANCA-associated vasculitis Cancer-associated vasculitis Others ANCA: antineutrophil cytoplasmic antibody; IgA: immunoglobulin A. Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013; 65:1. Reproduced with permission from John Wiley & Sons, Inc. Copyright 2013 by the American College of Rheumatology. All rights reserved. Graphic 90188 Version 4.0 https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 21/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate Definitions for vasculitides adopted by the 2012 International Chapel Hill Consensus Conference on the Nomenclature of Vasculitides (CHCC2012) CHCC2012 name CHCC2012 definition Large-vessel vasculitis Vasculitis affecting large arteries more often than other vasculitides. Large arteries are the aorta and its major branches. Any size artery may be affected. Takayasu arteritis (TAK) Arteritis, often granulomatous, predominantly affecting the aorta and/or its major branches. Onset usually in patients younger than 50 years. Giant cell arteritis (GCA) Arteritis, often granulomatous, usually affecting the aorta and/or its major branches, with a predilection for the branches of the carotid and vertebral arteries. Often involves the temporal artery. Onset usually in patients older than 50 years and often associated with polymyalgia rheumatica. Medium-vessel vasculitis Vasculitis predominantly affecting medium arteries defined as the main visceral arteries and their branches. Any size artery may be affected. Inflammatory aneurysms and stenoses are common. Polyarteritis nodosa (PAN) Necrotizing arteritis of medium or small arteries without glomerulonephritis or vasculitis in arterioles, capillaries, or venules, and not associated with antineutrophil cytoplasmic antibodies (ANCAs). Kawasaki disease (KD) Arteritis associated with the mucocutaneous lymph node syndrome and predominantly affecting medium and small arteries. Coronary arteries are often involved. Aorta and large arteries may be involved. Usually occurs in infants and young children. Small-vessel vasculitis Vasculitis predominantly affecting small vessels, defined as small intraparenchymal arteries, arterioles, capillaries, and venules. Medium arteries and veins may be affected. ANCA-associated vasculitis (AAV) Necrotizing vasculitis, with few or no immune deposits, predominantly affecting small vessels (ie, capillaries, venules, arterioles, and small arteries), associated with myeloperoxidase (MPO) ANCA or proteinase 3 (PR3) ANCA. Not all patients have ANCA. Add a prefix indicating ANCA reactivity, eg, MPO-ANCA, PR3-ANCA, ANCA-negative. Microscopic polyangiitis (MPA) Necrotizing vasculitis, with few or no immune deposits, predominantly affecting small vessels (ie, capillaries, venules, or arterioles). Necrotizing arteritis involving small and medium arteries may be present. Necrotizing glomerulonephritis is very common. Pulmonary capillaritis often occurs. Granulomatous inflammation is absent. Granulomatosis with polyangiitis (Wegener's) (GPA) Necrotizing granulomatous inflammation usually involving the upper and lower respiratory tract, and necrotizing vasculitis affecting predominantly small to medium vessels (eg, capillaries, venules, https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 22/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate arterioles, arteries and veins). Necrotizing glomerulonephritis is common. Eosinophilic Eosinophil-rich and necrotizing granulomatous inflammation often granulomatosis with polyangiitis (Churg- Strauss) (EGPA) involving the respiratory tract, and necrotizing vasculitis predominantly affecting small to medium vessels, and associated with asthma and eosinophilia. ANCA is more frequent when glomerulonephritis is present. Immune complex vasculitis Vasculitis with moderate to marked vessel-wall deposits of immunoglobulin and/or complement components predominantly affecting small vessels (ie, capillaries, venules, arterioles, and small arteries). Glomerulonephritis is frequent. Anti-glomerular basement membrane Vasculitis affecting glomerular capillaries, pulmonary capillaries, or both, with GBM deposition of anti-GBM autoantibodies. Lung (anti-GBM) disease involvement causes pulmonary hemorrhage, and renal involvement causes glomerulonephritis with necrosis and crescents. Cryoglobulinemic Vasculitis with cryoglobulin immune deposits affecting small vessels vasculitis (CV) (predominantly capillaries, venules, or arterioles) and associated with serum cryoglobulins. Skin, glomeruli, and peripheral nerves are often involved. IgA vasculitis (Henoch- Vasculitis, with IgA1-dominant immune deposits, affecting small Sch nlein) (IgAV) vessels (predominantly capillaries, venules, or arterioles). Often involves skin and gastrointestinal tract, and frequently causes arthritis. Glomerulonephritis indistinguishable from IgA nephropathy may occur. Hypocomplementemic Vasculitis accompanied by urticaria and hypocomplementemia urticarial vasculitis (HUV) (anti-C1q vasculitis) affecting small vessels (ie, capillaries, venules, or arterioles), and associated with anti-C1q antibodies. Glomerulonephritis, arthritis, obstructive pulmonary disease, and ocular inflammation are common. Variable-vessel vasculitis Vasculitis with no predominant type of vessel involved that can affect vessels of any size (small, medium, and large) and type (arteries, veins, and capillaries). Beh et's syndrome Vasculitis occurring in patients with Beh et's syndrome that can affect arteries or veins. Beh et's syndrome is characterized by recurrent oral and/or genital aphthous ulcers accompanied by cutaneous, ocular, articular, gastrointestinal, and/or central nervous system inflammatory lesions. Small-vessel vasculitis, thromboangiitis, thrombosis, arteritis, and arterial aneurysms may occur. Cogan's syndrome Vasculitis occurring in patients with Cogan's syndrome. Cogan's syndrome is characterized by ocular inflammatory lesions, including interstitial keratitis, uveitis, and episcleritis, and inner ear disease, including sensorineural hearing loss and vestibular dysfunction. Vasculitic manifestations may include arteritis (affecting small, https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 23/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate medium, or large arteries), aortitis, aortic aneurysms, and aortic and mitral valvulitis. Single-organ vasculitis Vasculitis in arteries or veins of any size in a single organ that has no features that indicate that it is a limited expression of a systemic vasculitis. The involved organ and vessel type should be included in the name (eg, cutaneous small-vessel vasculitis, testicular arteritis, central nervous system vasculitis). Vasculitis distribution may be unifocal or multifocal (diffuse) within an organ. Some patients originally diagnosed as having single-organ vasculitis will develop additional disease manifestations that warrant redefining the case as one of the systemic vasculitides (eg, cutaneous arteritis later becoming systemic polyarteritis nodosa, etc). Vasculitis associated with Vasculitis that is associated with and may be secondary to (caused by) systemic disease a systemic disease. The name (diagnosis) should have a prefix term specifying the systemic disease (eg, rheumatoid vasculitis, lupus vasculitis, etc). Vasculitis associated with probable etiology Vasculitis that is associated with a probable specific etiology. The name (diagnosis) should have a prefix term specifying the association (eg, hydralazine-associated microscopic polyangiitis, hepatitis B virus- associated vasculitis, hepatitis C virus-associated cryoglobulinemic vasculitis, etc). Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013; 65:1. Reproduced with permission from John Wiley & Sons, Inc. Copyright 2013 by the American College of Rheumatology. All rights reserved. Graphic 90189 Version 5.0 https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 24/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for Takayasu arteritis Considerations when applying these criteria These classification criteria should be applied to classify the patient as having Takayasu arteritis when a diagnosis of medium-vessel or large-vessel vasculitis has been made Alternate diagnoses mimicking vasculitis should be excluded prior to applying the criteria Absolute requirements Age 60 years at time of diagnosis Evidence of vasculitis on imaging* Additional clinical criteria Female sex +1 Angina or ischemic cardiac pain +2 Arm or leg claudication +2 Vascular bruit +2 Reduced pulse in upper extremity +2 Carotid artery abnormality +2 Systolic blood pressure difference in arms 20 mmHg +1 Additional imaging criteria Number of affected arterial territories (select one) +1 One arterial territory +2 Two arterial territories +3 Three or more arterial territories Symmetric involvement of paired arteries +1 Abdominal aorta involvement with renal or mesenteric involvement +3 Sum the scores for 10 items, if present. A score of 5 points is needed for the classification of Takayasu arteritis. Evidence of vasculitis in the aorta or branch arteries must be confirmed by vascular imaging (eg, computed tomographic/catheter-based/magnetic resonance angiography, ultrasound, positron emission tomography). Bruit detected by auscultation of a large artery, including the aorta, carotid, subclavian, axillary, brachial, renal, or iliofemoral arteries. https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 25/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate Reduction or absence of pulse by physical examination of the axillary, brachial, or radial arteries. Reduction or absence of pulse of the carotid artery or tenderness of the carotid artery. Number of arterial territories with luminal damage (eg, stenosis, occlusion, or aneurysm) detected by angiography or ultrasonography from the following 9 territories: thoracic aorta, abdominal aorta, mesenteric, left or right carotid, left or right subclavian, left or right renal arteries. Bilateral luminal damage (stenosis, occlusion, or aneurysm) detected by angiography or ultrasonography in any of the following paired vascular territories: carotid, subclavian, or renal arteries. Luminal damage (stenosis, occlusion, aneurysm) detected by angiography or ultrasonography involving the abdominal aorta and either the renal or mesenteric arteries. From: Grayson PC, Ponte C, Suppiah R, et al. 2022 American College of Rheumatology/EULAR classi cation criteria for Takayasu arteritis. Ann Rheum Dis 2022; 81:1654. Copyright 2022 The Authors (or their employers). Reproduced with permission from BMJ Publishing Group Ltd. Graphic 140336 Version 1.0 https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 26/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate Distinguishing features of giant cell versus Takayasu arteritis Finding Giant cell arteritis Takayasu arteritis Female-to-male ratio 3:2 7:1 Age at onset >50 years <40 years Ethnic ancestry European Asian Histopathology Granulomatous inflammation Granulomatous inflammation Primary vessels involved External carotid artery branches Aorta and branches Renovascular hypertension Rare Common HLA association HLA-DR4 HLA-Bw52 Course Self-limited Chronic Response to corticosteroids Excellent Excellent Surgical intervention needed Rare Common HLA: human leukocyte antigen. Adapted from Michel, BA, Arend, WP, Hunder, GG. Clinical di erentiation between giant cell (temporal) arteritis and Takayasu's arteritis. J Rheumatol 1996; 23:106. Graphic 68594 Version 2.0 https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 27/28 7/7/23, 11:13 AM Clinical features and diagnosis of Takayasu arteritis - UpToDate Contributor Disclosures Peter A Merkel, MD, MPH Equity Ownership/Stock Options: Kyverna [Systemic lupus erythematosus]. Grant/Research/Clinical Trial Support: AbbVie [Vasculitis]; AstraZeneca [Vasculitis]; Boehringer Ingelheim [Scleroderma]; Bristol-Myers Squibb [Vasculitis]; ChemoCentryx [Vasculitis]; Electra [Vasculitis]; Genentech/Roche [Vasculitis]; GlaxoSmithKline [Vasculitis]; InflaRx [Vasculitis]; Sanofi [Vasculitis]; Takeda [Vasculitis]. Consultant/Advisory Boards: AbbVie [Vasculitis]; AstraZeneca [Vasculitis]; Boehringer Ingelheim [Scleroderma]; Bristol-Myers Squibb [Vasculitis]; ChemoCentryx [Vasculitis]; CSL Behring [Scleroderma, vasculitis]; Dynacure [Vasculitis]; EMDSerono [Vasculitis]; GlaxoSmithKline [Vasculitis]; InflaRx [Vasculitis]; Janssen [Vasculitis]; Kyverna [Scleroderma, vasculitis]; MiroBio [Vasculitis]; Neutrolis [Vasculitis]; Novartis [Vasculitis]; NS Pharma [Vasculitis]; Otsuka [Vasculitis]; Q32 [Vasculitis]; Regeneron [Vasculitis]; Sparrow [Vasculitis]; Takeda [Vasculitis]. All of the relevant financial relationships listed have been mitigated. Kenneth J Warrington, MD Grant/Research/Clinical Trial Support: Eli Lilly [Giant cell arteritis]; GSK [Giant cell arteritis]; Kiniksa [Giant cell arteritis]. Other Financial Interest: Chemocentryx [Honoraria ANCA-associated vasculitis]. All of the relevant financial relationships listed have been mitigated. Philip Seo, MD, MHS No relevant financial relationship(s) with ineligible companies to disclose. Contributor disclosures are reviewed for conflicts of interest by the editorial group. When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content. Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence. Conflict of interest policy https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-takayasu-arteritis/print 28/28