The clinical characteristics of Chinese Takayasu’s arteritis patients: a retrospective study of 411 patients over 24 years

Abstract

BackgroundWe aimed to investigate the clinical characteristics of 411 Chinese Takayasu’s arteritis (TAK) patients using a retrospective analysis.MethodsWe retrospectively reviewed 810 medical charts of patients with a diagnosis of TAK who were admitted to Peking Union Medical College Hospital from 1990 to 2014. 411 patients with a complete dataset were finally included in the analysis. The demographic data, clinical features, angiographic patterns, and TAK-related surgical procedures were collected and analyzed.ResultsThe median age at disease onset was 23 (18, 30) years old, with a median disease duration of 21 (6, 60) months; 325 (79.1%) were female. The angiographic involvement pattern was type I in 91 (22.1%) patients, type IIa in 16 (3.9%) patients, type IIb in 16 (3.9%) patients, type III in 12 (2.9%) patients, type IV in 26 (6.3%) patients, and type V in 250 (60.8%) patients. Subclavian arteries (79.8%) were the most commonly involved, followed by carotid arteries (79.1%). The occurrence rate (4.1%) of aortic aneurysm in this study was low; 119 operations and interventions were performed. The most common cause of death in this study was heart failure.ConclusionSubclavian arteries, carotid arteries, and type V were the most frequently involved arteries and angiography pattern in this Chinese TAK study. The difference in angiographic features may lead to differences in clinical manifestations. Surgical operation and interventions should be performed at different stages of the disease course.

Takayasu Arteritis Presenting with Acute Critical Ischemia of Bilateral Lower Limbs

“…In Chinese population, Takayasu arteritis usually presented with non-specific symptoms i.e. fever, malaise, loss of weight, limb claudication, hypertension and vessel bruits [3]. Our patient presented with critical ischemia of bilateral lower limbs which was a rare presentation of Takayasu arteritis.…”

Takayasu Arteritis

“…Li J and colleagues have reported that they have detected 30% claudication in their studies. 5 Although there was no evidence of upper extremity claudication in the history and physical examination of our patient, there was a lower extremity pain which became evident during movement. Takayasu arteritis was thought to be caused by the claudication presentation of the case, the lack of blood pressure and pulselessness.…”

“…3,4 In Japan, the prevalence is reported as 4/100000, but according to autopsy reports this rate is one third / 3,000. 5 A study conducted by Fatih Sarıtaş from Turkey stated the incidence as 3,4 /1,000,000. 6 The etiopathogenesis is not clear, as is the case in many other vasculitis and autoimmune diseases.…”

“…Another study in which fourteen cases were evaluated stated that the non-specific findings could be seen in more than 30% of patients. 5 Our patient had fatigue, intermittent and unexplained fever, weight loss, occasional headache associated with different diagnoses like anemia. The time from the onset of the findings to the diagnosis was approximately one year, which is consistent with the literature.…”

Clinical Profile, Angiographic Findings and Outcomes Following Intervention in Patients With Takayasu’s Arteritis.

“…The clinical presentation in our study has been found to be similar to other observational studies done by Setty et al and Li et al; commonly encountered are constitutional symptoms, Hypertension, unequal pulses, BP difference and limb claudication. Rarer symptoms include limb gangrene, carotodynia and major organ involvement causing cerebrovascular accidents, bowel ischemia and heart valve impairment and coronary syndromes (4,6). The 1990 ACR diagnostic criteria used for the diagnosis of TA, given in the table below(7): Limb claudication 3.…”