Takayasu arteritis: clinical features and management: report of 272 cases

Mwipatayi, Bibombe P.; Jeffery, P.; Beningfield, Steve; Matley, Philip J.; Naidoo, Naid G; Kalla, Abdullah A; Kahn, D

doi:10.1111/j.1445-2197.2005.03312.x

Cited by 200 publications

(173 citation statements)

References 41 publications

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“…Its pathogenesis remains unclear, and existing studies have shown that multiple factors, such as immunity, genetics, infection, or sex hormones, may be involved in TA [4]. Studies have also shown that histocompatibility antigens have a significant correlation with TA [14]; a large number of epidemiological studies have shown that TA dominates in women, with a male to female sex ratio of 1:4. The levels of estradiol and progesterone in patients in either the active or stable stage are higher than those in healthy women, indicating that the elevated levels of sex hormones may be an important factor that can affect the pathogenesis of TA.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis

Zhang¹,

Li²,

Zhang³

2017

Ginekol Pol

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Objectives: To investigate the clinical features, disposition, and effect of pregnancy complicated with Takayasu arteritis (P-TA) on maternal and fetal outcomes. Material and methods:The clinical data (diagnosis and treatment, peri-pregnancy monitoring, and pregnancy outcomes) of patients with P-TA treated in our hospital between September 2007 and April 2016 were analyzed retrospectively.Results: Among the 13 P-TA cases, seven were diagnosed before pregnancy, and six were diagnosed during pregnancy; six cases were diagnosed as the generalized type, and seven cases were diagnosed as the cephalic-brachial type; six cases were in the stable stage, and seven cases were in the active stage. All the cases in the active stage underwent glucocorticoid therapy. Four cases developed complications, including cardiac dysfunction combined with preeclampsia in two cases, preeclampsia in one case, and stroke in one case. Eleven patients successfully delivered (nine cases of full-term delivery and two cases of premature delivery); one patient had late miscarriage; one patient had missed abortion. All the parturients survived and delivered 11 neonates (nine full-term neonates and two premature neonates) and one low-birth-weight neonate; no neonatal asphyxia or death occurred. Conclusions:Patients with P-TA can have better maternal and child outcomes through timely diagnosis and treatment, dynamic monitoring, or timely pregnancy termination.

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Section: Discussionmentioning

confidence: 99%

Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis

Zhang¹,

Li²,

Zhang³

2017

Ginekol Pol

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“…Active tuberculosis has been described in up to 20% of adult TA patients. 27 A retrospective study from India describes strongly positive Mantoux test in one-fifth of all TA patients. 28 Whether this association represents a causal relationship or a mere coincidence is still unclear and debatable.…”

Section: Differential Diagnosesmentioning

confidence: 99%

Childhood‐onset Takayasu arteritis: an update

et al. 2015

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Childhood-onset Takayasu arteritis (c-TA) is a distinct subset affecting a wide age group, ranging from young infants to adolescents and it differs from adult TA in many aspects. There is scarcity of data on c-TA worldwide. The disease is classified using the European League Against Rheumatism/Pediatric Rheumatology International Trials Organization/Pediatric Rheumatology European Society criteria. The non-specific nature of presenting complaints and lack of appropriate biomarkers delay the early diagnosis of this illness and many children present with complications, which become irreversible once they set in. One of the largest cohorts of 40 children with c-TA from our center reports hypertension as the commonest presenting feature. Systemic symptoms like headache, fever and weight loss are also described. Assessment of disease in c-TA is done by correlating clinical features with raised inflammatory markers. Advanced imaging plays an important role in diagnosis. In c-TA, the role of magnetic resonance angiography is advocated, taking into consideration the enormous amount of radiation exposure with other modalities. Complications of c-TA include cardiovascular, pulmonary, neurological and those arising secondary to long-term steroid and immunosuppression therapy.

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“…10,14,15,18) Severe hypertension, severe functional disability, and evidence of cardiac involvement are good predictors of either death or a major To manage active arteritis, an initial dose of corticosteroid administered at 1 mg/kg/day for one month, and then tapered down to less than 10 mg/day, is the initial mainstay of medical therapy for patients with Takayasu's arteritis. 4,9) However, studies report that only 20% of patients with Takayasu's arteritis maintain remission for 6 months on less than 10 mg prednisone.…”

Section: Discussionmentioning

confidence: 99%

“…5) Takayasu's arteritis often induces cerebrovascular accidents as well as ischemic heart disease, cardiac failure, aneurysm, renal failure, retinopathy, and hypertension. 10,15,18) The overall survival percentage in patients with Takayasu's arteritis at 10 years after diagnosis is 80.3%, and the event-free survival percentage at 10 years is 61.6%. 15) However, the treatment for Takayasu's arteritis has not been well established to date.…”

Section: Introductionmentioning

confidence: 98%

Single Stage Multiple Stenting in Takayasu's Arteritis

Miyamoto

Kubo

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A 32-year-old Filipino female presented with Takayasu's arteritis manifesting as an abrupt onset of syncope. Physical examination revealed diminished consciousness, right hemiparesis, and a large discrepancy in blood pressure between the upper and lower extremities. Magnetic resonance imaging revealed cerebral infarcts in the left basal ganglia and the left temporal lobe. Angiography revealed complete occlusion of the left common carotid artery and severe stenosis of the brachiocephalic artery, the right common carotid artery, and the left subclavian artery. Based on the clinical examination and studies, the diagnosis was Takayasu's arteritis, type I. The patient's condition stabilized after 2 months of prednisone and anti-platelet therapy. Single stage multiple stenting in the brachiocephalic artery, the right common carotid artery, and the left subclavian artery was then performed using high pressure inflation to dilate the arteries due to the remarkably rigid lesions that resulted from extensive and diffuse fibrosis throughout the vessel walls. Although a small intimal flap occurred during inflation of the left subclavian artery, re-dilation was possible with the stent. Even with evidence of notable recovery in blood pressure and cerebral blood flow, no further neurological improvement was observed. In view of the favorable short-and intermediate-term results, single stage multiple stenting may be the optimum treatment option for first-line stent-supported angioplasty in patients with Takayasu's arteritis.

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Takayasu arteritis: clinical features and management: report of 272 cases

Abstract: The natural history and prognosis of Takayasu's arteritis still remain poorly defined.

Cited by 200 publications

References 41 publications

Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis

Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis

Childhood‐onset Takayasu arteritis: an update

Single Stage Multiple Stenting in Takayasu's Arteritis

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