Takayasu's arteritis: A study of 104 Italian patients

Abstract

Objective. Takayasu's arteritis (TA) is a rare vasculitis. The Italian Takayasu's Arteritis study group was established with the aim to describe a large cohort of patients. Methods. Data were collected by means of an ad hoc form. Demographic information, clinical history, vascular findings, treatment, risk factors, and comorbidities were analyzed. Results. Data of 104 patients were collected. The median delay in diagnosis was 15.5 months (range 0 -325 months). Age at onset <15 years was associated with a higher probability, whereas elevated erythrocyte sedimentation rate with a lower probability, of a delay in diagnosis. The majority of patients experienced nonspecific signs and symptoms indicative of an inflammatory disease in the early phase. Among vascular involvement, stenosis was the most frequent lesion, being present in 93% of patients, followed by occlusion (57%), dilatation (16%), and aneurysm (7%). Glucocorticoids were the mainstay of treatment in our series; however, treatment with cytotoxic agents was required in about half of the patients. Fifty-two patients underwent at least 1 surgical procedure. The main indications for intervention were renal vascular hypertension, cerebral hypoperfusion, and limb claudication. Conclusion. As with many rare diseases, delay in diagnosis is an important issue for patients with TA. The increasing occurrence of vascular lesions along with the disease progression put to question the long-term effectiveness of contemporary treatment. These data may be helpful in increasing physicians' awareness to prevent diagnosis delay, update guidelines, and plan future research projects.

Positron emission tomography (PET): Evaluation of chronic periaortitis

“…TA primarily targets the subclavianaxillary and proximal brachial arteries in a pattern indistinguishable from that of large-vessel GCA (28). However, the abdominal aorta, renal, and mesenteric superior arteries are involved in 30 -40% of patients with TA.…”

Single Stage Multiple Stenting in Takayasu's Arteritis

“…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.…”

“…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.…”

Takayasu arteritis: is disease activity assessment possible?

“…W badaniu włoskim, które objęło 104 chorych na TA, 80% z nich miało przyspieszony OB w chwili ustalenia rozpoznania. Stwierdzono, że wyjściowa prędkość OB ≤ 30 mm/h wią-zała się z opóźnieniem postawienia diagnozy o 2 lub wię-cej lat [40].…”