Aggressive Progression of Takayasu’s Arteritis in Infancy: A Case Report

Pavić, Roman

doi:10.20471/acc.2019.58.03.19

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…Clinical manifestations of TA are nonspecific in infants and children. Fever and inflammation are the most common manifestations, and the abdominal aorta is the most commonly involved vessel [5,[10][11][12][13][14][15]. In our series, eight (80%) cases had fever as the first symptom and most prominent clinical manifestation.…”

Section: Discussionmentioning

confidence: 54%

Clinical observations on infliximab treatment of infantile onset Takayasu arteritis

et al. 2022

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Background There is insufficient evidence on the clinical effectiveness and safety of infliximab (IFX) treatment of Takayasu arteritis (TA) in infants. Methods We evaluated the therapeutic effectiveness and safety of IFX in a retrospective case series of 10 infantile TA patients. Observations included assessment of clinical symptoms, laboratory testing, and vascular imaging. Results Fever was the presenting symptom for 8 of 10 infants with TA. During acute episodes, leucocyte and inflammatory indices were significantly increased. Vascular imaging showed the most commonly involved arteries to be carotid arteries, abdominal aortas, and coronary arteries (9 cases, 90%). Two weeks after initiating IFX treatment, leukocyte and platelet counts decreased and hemoglobin levels increased. There were statistically significant clinical improvements 6 weeks after starting treatment compared with before treatment (p < 0.05). Inflammatory indices decreased 2 weeks after starting IFX treatment compared with before treatment (p < 0.05). Vascular lesions began to recover within 1.5-3 months of initiating IFX therapy, and involved vessels significantly recovered within 13 months. Some arteries remained stenotic, with intimal thickening and uneven lumen wall thicknesses. The only adverse event was a treatment-responsive allergic reaction during IFX infusion in one infant. Conclusions Fever was the main manifestation of illness and was often accompanied by significantly increased inflammatory indices. IFX treatment was apparently effective and reduced or eliminated need for glucocorticoids. IFX had a reasonably good safety profile.

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Section: Discussionmentioning

confidence: 54%

Clinical observations on infliximab treatment of infantile onset Takayasu arteritis

et al. 2022

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“…Clinical manifestations of TA are nonspeci c in infants and children. Fever and in ammation are the most common manifestations; the abdominal aorta is the most commonly involved vessel [10][11][12][13][14][15][16]. In our series, eight (80%) cases had fever as the rst symptom and most prominent clinical manifestation.…”

Section: Discussionmentioning

confidence: 64%

Clinical Observations on Infliximab Treatment of Infantile Onset Takayasu Arteritis

Kang

Lai

Zhang

et al. 2022

Preprint

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Background To study short-term clinical effectiveness and safety of infliximab (IFX) treatment of infants with Takayasu arteritis (TA). Methods We investigated the therapeutic effectiveness of IFX in 10 infantile TA in a retrospective case series. Evaluation included assessment of clinical symptoms, laboratory testing, and vascular imaging. Results Fever was the presenting symptom for 8 of 10 infants with TA. In the acute episode, leucocyte and inflammatory indices increased significantly. Vascular imaging showed that the most commonly-involved arteries were carotid arteries, abdominal aortas, and coronary arteries (9 cases, 90%). Two weeks after IFX treatment, leukocyte and platelet counts decreased, and hemoglobin levels increased. There were significant clinical differences 6 weeks after treatment compared with before treatment (p<0.05). Inflammatory indices decreased significantly 2 weeks after starting IFX treatment compared with before treatment (p<0.05). Vascular lesions began to recover within 1.5-3 months of initiating IFX therapy, and the involved vessels significantly recovered within 13 months. Some arteries remained stenotic, intimal thickening and uneven lumen wall thickness. Conclusions TA is rare in infancy. Fever may be the main manifestation of illness, often accompanied by significantly increased inflammatory indices. Early use of IFX appears to be effective, significantly decreasing inflammatory markers and improving clinical features, leading to partial remission of vascular lesions and sustain remissions for some infants. Use of IFX reduced or eliminated need for glucocorticoids. IFX has a reasonable safety profile and does not appear to affect normal growth and development of infants with TA.

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“…Ohigashi et al [33] reported that the incidence of CAD in adult patients with TAK increased with age. In contrast, Shi-Min et al [34] reported that the age of patients with TAK combined with CAL was mostly < 40 years. After multivariate analysis, Wang et al [11] proposed that age at onset, disease course, height, and body mass index (BMI) were risk factors for adult TAK involving the coronary arteries.…”

Section: Discussionmentioning

confidence: 93%

Clinical characteristics and risk factors of coronary artery lesions in Chinese pediatric Takayasu arteritis patients: a retrospective study

Luo²,

Kang

et al. 2023

Preprint

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Backgroud: To summarize the clinical characteristics and identify the risk factors for pediatric Takayasu arteritis (TAK) with coronary artery lesions (CALs). Methods: Clinical data of pediatric TAK patients in our center were retrospectively assessed. Independent risk factors for CALs were identified using multivariate logistic regression analysis. Survival analysis was used to compare differences in survival rates between the groups. Results: Among the 66 pediatric TAK cases, the incidence of accompanying CALs was 39.4%. The children in the CAL group were all subclinical, and the coronary arteries most commonly involved were the left main and right coronary arteries. The CALs were mostly small or middle coronary artery aneurysms; some children may have giant coronary aneurysmal dilations. Univariate logistic regression analysis showed that age at onset, white blood count, hemoglobin, platelet count, interleukin-2 receptor, and renal artery stenosis (RAS) were associated with pediatric TAK combined with CAL(P < 0.05). In multivariate logistic regression, the age of onset and RAS were predictive factors associated with pediatric TAK combined with CAL (P < 0.05). A cutoff value of 54.75 months maximized the diagnostic efficacy combined with CAL. In addition, there was no significant difference in survival rates between the two groups after regular treatment. Conclusion: This study showed that the occurrence of CAL in pediatric TAK patients has a relatively more rapid clinical course, and a stronger inflammatory state at the time of diagnosis. Early onset is more likely to cause CAL. Pediatric TAK patients with RAS were less likely to develop CAL.

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Aggressive Progression of Takayasu’s Arteritis in Infancy: A Case Report

Cited by 7 publications

References 18 publications

Clinical observations on infliximab treatment of infantile onset Takayasu arteritis

Clinical observations on infliximab treatment of infantile onset Takayasu arteritis

Clinical Observations on Infliximab Treatment of Infantile Onset Takayasu Arteritis

Clinical characteristics and risk factors of coronary artery lesions in Chinese pediatric Takayasu arteritis patients: a retrospective study

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