Glomerulonephritis associated with Takayasu arteritis

Abstract

Purpose: Takayasu arteritis (TAK) is a large vessel granulomatous vasculitis usually seen before 50 years of age. While TAK may involve renal artery and its branches, its association with glomerulonephritis is rare. Main objective of this study is to introduce three new cases of TAK-associated glomerulonephritis with a review of literature. Methods: TAK cases followed in Gazi University rheumatology clinic were retrospectively analyzed using chart review. Cases associated with glomerulonephritis were selected. Demographic, clinical, laboratory, radiological and pathological data were extracted from patient charts. Literature review was conducted using keywords “Takayasu” and “glomerulonephritis” via PubMed. Cases with patients younger than 16 years of age and potential confounding co-morbidities such as presence of SLE or ANCA positivity were excluded. Results: Three cases of glomerulonephritis were found among 72 TAK cases (4%). All cases of glomerulonephritis were diagnosed after the diagnosis of TAK. Two of the cases were mesangioproliferative glomerulonephritis and one case was focal segmental glomerulosclerosis. The literature review identified 28 cases of TAK-associated glomerulonephritis. Median duration of disease was 9 years. Majority of TAK cases were Numano type V or I, with about 22% of cases involving renal artery. Most common type of glomerulonephritis associated with TAK was mesangial glomerulonephritis, followed by membranoproliferative glomerulonephritis. Conclusions: Glomerulonephritis is rarely associated with TAK. However, it should be considered when evaluating a TAK patient with clinical features indicative of glomerulonephritis, such as new-onset proteinuria that cannot be explained otherwise