Document Detail


Longitudinal study of 16 patients with Takayasu's arteritis: clinical features and therapeutic management.
MedLine Citation:
PMID:  18797980     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Takayasu's arteritis (TA) is a rare vasculitis that affects the aorta and its primary branches. Heterogeneous clinical manifestations have been described in different geographical areas. We aimed to evaluate demographic, clinical, and angiographic features and the outcome in 16 TA patients who were followed in a single center in Serbia. TA was diagnosed according to the 1990 American College of Rheumatology criteria with median delay of 2 years. The majority of patients (81%) experienced one or more disease relapses and long-term remission was achieved in 94%. Five-year survival rate was 94%. Common systemic manifestations at disease onset included fever (69%), arthralgia (25%), weight loss (19%) and vascular symptoms, arm claudication (100%), headaches (69%), dizziness (56%), and hypertension (37%). All patients had multiple arterial bruits with diminished/absent left arm pulse in 88%. The raised erythrocyte sedimentation rate and C-reactive protein levels were found in 63% and 80%, respectively. Angiography revealed stenotic or occlusive sites of multiple arterial involvement. Stenosis of the left subclavian artery was the most frequent lesion (88%). The angiographic classification was as follows, 50% type I, 19% type IIa, and 31% type V arteritis, suggesting relatively favorable vascular lesions and infrequent serious complications. Glucocorticoids were the main initial therapy for active disease; however, treatment with additional immunosuppressive agents was required in two-thirds of the patients. Seven patients (44%) underwent one or multiple surgical interventions. The main indications for surgery were cerebral hypoperfusion, severe limb claudication, and gangrenous infection. The demographic and angiographic disease patterns in our cohort were similar to American, Italian, Japanese, and Korean cohorts in terms of frequent involvement of the branches of aortic arch and differed from cohorts from other Asian countries in which abdominal aorta and renal artery involvement prevailed.
Authors:
Ljiljana Petrovic-Rackov; Nada Pejnovic; Miodrag Jevtic; Nemanja Damjanov
Publication Detail:
Type:  Journal Article     Date:  2008-09-17
Journal Detail:
Title:  Clinical rheumatology     Volume:  28     ISSN:  1434-9949     ISO Abbreviation:  Clin. Rheumatol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2008-12-23     Completed Date:  2009-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211469     Medline TA:  Clin Rheumatol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  179-85     Citation Subset:  IM    
Affiliation:
Clinic of Rheumatology and Clinical Immunology, Military Medical Academy, Crnotravska 17, 11000 Belgrade, Serbia. ljrackov@eunet.yu
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiography
Arthralgia / etiology,  physiopathology*
Blood Sedimentation
C-Reactive Protein / metabolism
Constriction, Pathologic / etiology,  physiopathology*,  surgery
Disease Progression
Female
Fever / etiology,  physiopathology*
Follow-Up Studies
Glucocorticoids / therapeutic use
Humans
Hypertension / etiology,  physiopathology*
Immunosuppressive Agents / therapeutic use
Longitudinal Studies
Middle Aged
Recurrence
Siberia
Takayasu Arteritis / complications,  physiopathology*,  therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Glucocorticoids; 0/Immunosuppressive Agents; 9007-41-4/C-Reactive Protein

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