—It is pleasing to know that captopril is being used in Takayasu's disease, as is testified again by Dr Pirttiaho's letter.
As to the renal deterioration that these patients are prone to have, we would point out that the dosage of captopril administered, 300 mg, is sometimes likely to lead to renal failure even in patients who do not have Takayasu's disease.
Regarding the statement that Takayasu's disease is an autoimmune disease, we would like to stress that according to Ishikawa and Matsuura,1-3 the disease is of unknown origin and etiology and pathogenesis can only be speculative. Weiss and colleagues4 stressed that immunofluorescence examination was negative for IgG, IgM, IgA, C3, C4, and fibrinogen.
We think that the drug can safely be used in Takayasu's disease as in others—due care being taken, of course, to prescribe small doses in patients with renal problems.
Grossman E, Knecht A, Rosenthal T. Captopril in Takayasu's Disease-Reply. Arch Intern Med. 1985;145(1):180. doi:10.1001/archinte.1985.00360010228051