AB0586 TAKAYASU ARTERITIS: REVIEW OF DIAGNOSTIC AND CLASSIFICATION CRITERIA IN A 9 CASE SERIES

Abstract

Background: Takayasu arteritis (TA) is a rare large vessel vasculitis that affects the aorta (Ao) and its main branches. Early diagnosis and the rapid establishment of treatment are key points in the prognosis of the disease. Despite the existence of different classification and diagnostic criteria, early diagnosis of TA continues to be a challenge. Objectives: 1) To analyze the concordance between the different classification and diagnostic criteria in patients with TA, 2) To describe the demographic, clinical and analytical characteristics of TA. Methods: Retrospective observational study that included all patients diagnosed with TA according to medical criteria between 1981 and 2018, visited in a Rheumatology unit. Demographic, clinical, analytical and image data were collected. It is assumed that the vascular territories affected and the type of vascular involvement can be evaluated by angio-CT, angio-MRI and PET-CT with contrast iv. in case angiography is not performed. Ishikawa diagnostic criteria, 1990 ACR classification criteria and Ishikawa’s diagnostic criteria modified by Sharma were evaluated. Results: We included 9 patients (77.8% women) diagnosed with TA. The age at diagnosis was 33.3 ±16.3 years with a time of evolution of 5.1 ±9.4 years. The other variables are shown in Table 1. The most frequent vascular territories afected were abdominal Ao (7), descending thoracic Ao (5) and iliac arteries (5). The most common type of arterial lesion was stenosis (8) followed by dilation and aneurysm. 6 patients were treated with corticotherapy as an induction treatment, 5 required chronic immunosuppression and 6 patients required surgery. When reviewing the criteria we observed that all patients met the ACR criteria and 7 patients met the modified criteria by Sharma. However, the agreement with Ishikawa’s diagnostic criteria was poor since 7 patients did not meet them. The different criteria are shown in Table 2. Conclusion: The most frequently affected vascular territory was the abdominal Ao, and the most common type of injury was stenosis. The most common clinical presentation was asymmetry of blood pressure between extremities and peripheral pulses, HTA and limb claudication. All patients met the ACR 1990 classification criteria and the great majority met the criteria modified by Sharma. The concordance with Ishikawa’s criteria was poor so they should be used cautiously. Disclosure of Interests: Andrea Garca-Guilln: None declared, Patricia Moya: None declared, Antonio Jos Barros-Membrilla: None declared, Jaime Flix Dilme: None declared, Jos Montiel: None declared, Jos Alberto Hidalgo: None declared, Albert Flotats: None declared, Alejandro Fernandez: None declared, Josep Maria Llobet: None declared, Berta Magallares: None declared, Ana Laiz Consultant for: Lilly, Novartis, AbbVvie, MSD, UCB and Janssen, Speakers bureau: Lilly, Novartis, Abvvie, MSD, UCB and Janssen, Ivan Castellv Consultant for: I received fees less than 5000USD as a consultant for Kern and Actelion, Paid instructor for: I received fees less than 2000USD as a instructor for Boehringer -Ingelheim, Novartis and Gebro, Speakers bureau: ND, Hector Corominas: None declared