Takayasu's Disease Research Articles

Impact of conventional and biological disease-modifying anti-rheumatic drugs on arterial lesions in Takayasu arteritis.

The definition of Takayasu arteritis (TAK) remission and disease activity is still unclear. Vascular imaging is an essential tool for following-up patients. Herein, we aimed to compare the evolution of vascular lesions (ie vessel wall thickening and stenosis) under conventional disease-modifying anti-rheumatic drugs (cDMARDs) relatively to biological DMARDs (bDMARDs) in TAK patients followed with the same CT angiography modalities. We compared 75 lines of therapy in TAK patients who received cDMARDs (n = 40 lines) and bDMARDs (n = 35 lines) using CT angiography. We established 1-3 main target vessels with vessel wall thickening and/or stenosis. Every targeted vessel had its thickness and its lumen diameter measured at the initiation of immunosuppressive treatment and at 12 months. We observed an overall reduction of arterial wall thickness in 73% of cases and 31% had >25% of wall thickness relative decrease. Using a linear mixed effects model, first line immunosuppressive therapy (p= 0.012) and bDMARDs relatively to cDMARDs (p= 0.026) were independently associated with vessel wall thickness reduction in TAK. Thirty-eight percent of the stenotic vessels had a > 25% relative increase in lumen diameter under immunosuppressive therapy. The relative increase >25% in lumen diameter was noted in 56% vs 17% with bDMARDs compared with cDMARDs. Immunosuppressive treatments can reduce arterial wall thickness and widen lumen diameter in TAK. bDMARDs seems to be more effective than cDMARDs to improve arterial lesions in TAK.

Takayasus’s Arteritis in Pregnancy: Case Report and Literature Review

Takayasu arteritis is a chronic idiopathic vasculitis affecting the aorta and its primary branches. It affects women of reproductive age and leads to an increased risk of cardiovascular complications. We report the case of a 34-year-old gravida, with Takayasu's disease who presented at 37 weeks of amenorrhea pre-eclampsia which was taken care of at the anesthesia and intensive care unit of the maternity of Ibn Sina Hospital Center in Rabat Morocco with a favorable outcome of her delivery. During pregnancy, one should pay special attention to these patients. The objective of this report was to present the peripartum anesthetic care of a patient with Takayasu arteritis and a review of the literature.

Inflammatory disease of the orbit: A case series

Inflammatory orbital pseudotumors are a heterogeneous group of diseases characterized by their sensitivity to corticosteroid treatment regardless of the underlying etiology. Histological examination is generally performed following a lack of response to steroids, progressive neurological involvement, or suspicion of malignancy on radiological imaging. Herein, we report three clinical cases presented to our internal medicine department. The first case underscores the need for enucleation of the orbit due to the aggressiveness of orbital pseudotumors. This first case revealed Takayasu disease in a 39-year-old patient. Following the failure of corticosteroid therapy, favorable progression was achieved with adalimumab. Our second case concerns a 49-year-old woman presenting with exophthalmos, demonstrating rapid improvement in both clinical and biological parameters on corticosteroid administration. However, despite clinical amelioration, the partial radiological persistence of the orbital tumor prompted a positron emission tomography scan, revealing intense metabolic activity in the orbit despite the absence of clinical symptoms. Given the impracticability of biopsy, treatment with anti-CD20 was proposed, yielding a favorable radiological response. The third case describes an inflammatory orbital pseudotumor revealed by hemolytic anemia, with improved clinical and biological parameters observed over a 6-month period.

The incidence of vasculitides in Israel from 2007 to 2021 and during the COVID-19 pandemic.

The incidence of various types of vasculitis conditions over time, specifically during coronavirus disease 2019 (COVID-19), is unknown. We aimed to assess recent trends in vasculitides and the effect of the COVID-19 pandemic on these trends. We conducted a retrospective analysis of Israel's largest Health Maintenance Organization, which covers over 4.7 million patients and represents 55% of the country. We calculated the age- and sex-adjusted incidence of giant cell arteritis (GCA), Takayasu, ANCA-associated vasculitis (AAV), IgA vasculitis, cryoglobulinemia, and Behcet's disease (BD) during 2007-2021. We analyzed associations of COVID-19 with the incidence of each of the examined conditions. During 2007-2021, the adjusted annual incidence decreased from 7.9 (95% confidence interval (CI) 3.5-17.9) to 1.5 (95% CI 0.7-3.6) per 100,000 for GCA, from 5.2 (95% CI 2.7-11.1) to 1.5 (95% CI 0.7-3.3) per million for IgA vasculitis, and from 6.3 (95% CI 3.0-13.5) to 1.0 (0.5-2.5) per 100,000 for BD. The relative risks for these conditions decreased: 0.92 (95% CI 0.91-0.93), 0.93 (95% CI 0.89-0.98), and 0.90 (95% CI 0.85-0.94), respectively. The incidences of Takayasu, AAV, and cryoglobulinemia remained unchanged. The COVID-19 pandemic was not associated with changes in the incidence of any examined vasculitides. The incidences of GCA, IgA vasculitis, and BD decreased substantially in Israel during 15 years and were unaffected by the COVID-19 pandemic. Future studies should focus on possible environmental contributions to these findings.

Severe course of type IV Takayasu disease during treatment with etanercept.

Severe course of type IV Takayasu disease during treatment with etanercept.

A rare association of Takayasu's disease and inflammatory bowel disease in Gabon

Takayasu's disease is a vasculitis affecting large vessels, particularly the aorta and its main branches, for which the role of Mycobacterium tuberculosis has been suggested as a trigger by a hypersensitivity reaction. Inflammatory bowel diseases, which in sub-Saharan Africa can be confused with parasitic diseases, can rarely be found in association with Takayasu's disease. We report an association between both diseases in the Gabonese population.

Неспецифічний аортоартеріїт (хвороба Такаясу): клінічний випадок у педіатричній практиці

The article presents modern data on a relatively rare and life-threatening disease - non-specific aortoarteritis (Takayasu's disease) and its features in childhood. This disease belongs to the group of systemic vasculitis, which is based on non-specific non-infectious inflammation of the aorta and its branches, which leads to deformation of the vascular lumen and secondary tissue ischemia. Damage to vital organs in this disease leads to the development of severe complications and the risk of sudden death. Purpose - to cite a case of Takayasu's disease from our own practice, taking into account the rarity of the disease, lack of awareness and clinical vigilance of pediatricians and family doctors regarding this pathology. A clinical case of non-specific aortoarteritis in a 17-year-old patient who was examined and treated at the Ivano-Frankivsk Regional Children's Hospital was considered. Features of clinical symptoms, laboratory biomarkers, methods of visualization the level of lesions of main vessels are given. Information on methods of treatment of this patient according to the updated recommendations of the European Antirheumatic League (EULAR, 2018) is provided. Conclusions. Nonspecific aortoarteritis is a rare, difficult to diagnose and insufficiently studied autoimmune disease. Late diagnosis significantly increases the risk of a child's sudden death. Modern non-invasive imaging methods are crucial for making a diagnosis, assessing the extent of the disease and choosing treatment tactics. The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the child's parents and the patient was obtained for the description of the clinical case. No conflict of interests was declared by the authors.

Clinical Characteristics and Outcomes of Aortic Arch Emergencies: Takayasu Disease, Fibromuscular Dysplasia, and Aortic Arch Pathologies: A Retrospective Study and Review of the Literature.

In this study, 82 (1.07%) consecutive patients with NA-AAPs (including 38 TAKs, 26 FMDs, and 18 other AAPs) out of 7645 patients who underwent endovascular treatment (EVT) for the aortic arch and its side-branch diseases at a single institution between 2002 and 2022 were retrospectively reviewed. The recorded demographic, biochemical, diagnostic, operative, and postoperative factors were reviewed, and the functional outcomes were determined during follow-up. A systematic review of the literature was also performed. The study group comprised 65 (79.3%) female and 17 (21.7%) male subjects with a mean age of 46.1 ± 14.9 years. Overall, 62 (75.6%) patients were diagnosed with either cerebral ischemia symptoms or aortic arch dissection on admission. The EVT was feasible in 59 (72%) patients, whereas 23 (28%) patients were referred for medical treatment. In EVT patients, severe periprocedural complications occurred in two (3.39%) patients, including one periprocedural death and one cerebral hyperperfusion syndrome. During a median follow-up period of 64 months, cardiovascular events occurred in 24 (29.6%) patients (5 deaths, 13 ISs, and 6 myocardial infarctions). Repeated EVT for the index lesion was performed in 21/59 (35.6%) patients, including 19/33 (57.6%) in TAK and 2/13 (15.4%) in FMD. In the AAP group, one patient required additional stent-graft implantation for progressing dissection to the iliac arteries at 12 months. A baseline white blood count (odds ratio [HR]: 1.25, 95% confidence interval [CI]: 1.11-1.39; p < 0.001) was the only independent prognostic factor for recurrent stenosis, while a baseline hemoglobin level (HR: 0.73, 95%CI: 0.59-0.89; p = 0.002) and coronary involvement (HR: 4.11, 95%CI: 1.74-9.71; p = 0.001) were independently associated with a risk of major cardiac and cerebral events according to the multivariate Cox proportional hazards regression analysis. This study showed that AAPs should not be neglected in clinical settings, as it can be a life-threatening condition requiring a multidisciplinary approach. The knowledge of prognostic risk factors for adverse outcomes may improve surveillance in this group of patients.

Arterial Hypertension in Takayasu's Disease: Apropos of 14 cases

Arterial Hypertension in Takayasu's Disease: Apropos of 14 cases

Takayasu's Arteritis with Aortic Insufficiency as Initial Presentation: A Case Report

Takayasu's disease is the first cause of inflammatory aortitis in young subjects. The disease preferentially affects the women. Takayasu's disease could be a mode of non-specific reaction of the aorta to various infectious or dysimmune etiological factors. Aortic insufficiency is present in 7 to 10% of cases. It is usually moderate. Its mechanism is not unambiguous: direct damage to the aortic valves or dilation of the aortic annulus. Coronary damage responsible for angina or even myocardial infarction are also possible. We report the case of a severe aortic insufficiency secondary to takayasu disease complicated by acute coronary syndrome in a 42-year-old woman.

Takayasu's arteritis - a summary of current, clinically relevant knowledge of the disease

Takayasu's disease, also known as pulseless disease or aortic arch syndrome, is a rare inflammation of the aorta and its branches, and sometimes the pulmonary arteries, which, according to studies, occurs most frequently in people from the Far East and Asian countries. In addition, its incidence is significantly higher in women, and the mean age of affected patients is 45.4 years [1]. The first official clinical case report of the disease by Shimizu and Sano appeared in 1951, while the name of the disease was proposed by Cassamise and Okuda in 1954 to honour the first clinician, Mikito Takayasu, who as early as 1908 presented a case of a young female patient with characteristic fundus lesions associated with pulse disturbances [2].

Takayasu disease with depression responded to vortioxetine

Takayasu disease with depression responded to vortioxetine

The impact of the COVID-19 pandemic on patients with systemic vasculitis: a single-centre retrospective study.

This study aimed to study the impact of the COVID-19 pandemic on patients living with systemic vasculitis in Kazakhstan. A single-centre retrospective study of the medical histories of 82 patients was carried out based on the regional clinical hospital of the city for all admissions with systemic vasculitis in the period from January 2019 to December 2021. The following qualitative (gender, disability, concomitant diseases) and quantitative (age, disease experience, laboratory data, etc.) variables were studied. To conduct the study, the criteria for the inclusion and exclusion of patients in the study were determined. According to the results of the study, there is a decrease in the number of hospitalized patients with vasculitis in the rheumatology department of the regional clinical hospital. Compared to 2019, in 2021, the number of hospitalized patients decreased by almost half (Table 1).Out of 82 cases, the most common was Takayasu disease (nonspecific aortoarteritis) (43.9%), IgA-vasculitis (Schenlein-Genoch disease) (31.71%), and they are typical mainly for females of rural origin, who were admitted to the hospital in a comorbid state (p < 0.001). 41.6% of patients have disabilities, and the majority of patients have a II disability group. The average body mass index is 24.2; 27 patients out of the total number of patients suffer from obesity. The most common clinical symptoms of patients with systemic vasculitis were injuries of the musculoskeletal system (75.6%). A negative average correlation was found between the indicators of the level of ESR and haemoglobin, the correlation coefficient is -0.535. The patients had concomitant diseases, such as diabetes mellitus, iron deficiency anaemia, coronary heart disease, hypertension, gastrointestinal tract diseases and hepatitis. Women of reproductive age from rural areas are often diagnosed with systemic vasculitis. A high rate of disability revealed among the patients can be explained by two main factors, the first is that the patients consulted the doctors untimely and the second is that the medical community are insufficiently informed about the management of autoimmune rheumatic diseases, in particular about systemic vasculitis, which hinders timely diagnosis and treatment, respectively. Patients, included in this survey, were mostly suffering from diseases of the musculoskeletal system, but depending on the type of vasculitis, other organs and systems may be affected. Table 1 Frequency of patients with systemic vasculitis over 3years Year Frequency % p-value 2019 42 51.2 χ2 = 12.463a; p = 0.002 2020 23 28.0 2021 17 20.7 Total 82 100.0.

Takayasu's disease presenting with tubercular empyema: A rare presentation of a rare disease

Takayasu's disease presenting with tubercular empyema: A rare presentation of a rare disease

PS-C37-1: EFFICACITY OF COMBINATION ACID ACETYLSALICYLIC AND GLUCOCORTICOID IN TAKAYASU ATERITIS TREATMENT: A CASE CLINIC TAKAYASU ARTERITIS IN VIET NAM

A young female 14 years old was detected with Takayasu arteritis in December 2018. We started the therapy with glucocorticoid 20 mg/ day in the first month, and then additive acid acetylsalicylic (Aspirin) 81 mg/day, in addition to the other drugs such as ACEi, a beta-blocker. After 12 months, this therapy bring results positive that were demonstrated via the value C- reactive protein (CRP) from high to normal, and the image of an aortic aneurysm in CT scan is nearly the normal size after treatment. This is the first time that the combination of glucocorticoid and antiplatelet showed benefit in Takayasu disease in Viet Nam. This is a chance for the patients who are diagnosed with Takayasu arteritis, instead of using invasive methods such as aortic stent placement or operations. JOURNAL/jhype/04.03/00004872-202301001-01260/figure1/v/2023-10-24T163949Z/r/image-jpeg

Takayasu Disease Revealed by Arterial Hypertension in a 47-Year-Old Man

Takayasu Disease Revealed by Arterial Hypertension in a 47-Year-Old Man

Asymptomatic Acute Dissection of the Abdominal Aorta as a Rare Complication of Takayasu Disease

The present study describes a case of a 24-year-old who had an asymptomatic acute dissection of the abdominal sub-renal aorta along with an inflammatory syndrome suggestive of Takayasu disease. Aortic dissection is a rare complication of Takayasu's disease that has only been reported a few times in the literature. The type of aortic dissection (type III b, according to the classification of De Bakey and Stanford) confirmed by computed tomography scan of the aorta (CT scan) in our patient. The patient underwent conservative medical treatment.

Might IgA be a Biomarker of Disease Activity in Takayasu Arteritis?

This case report highlights the need to increase the number of humoral markers used to assess disease course in Takayasu arteritis (TA).IgA may be considered a biomarker of TA disease activity.Serum IgA levels may be helpful to identify TA patients not responding to traditional therapy.

Takayasu’s Arteritis Associated with Crohn’s Disease and Autoimmune Thyroiditis: An Unusual Association with Diagnostic and Therapeutic Difficulties

The coexistence of Crohn's disease (CD) and Takayasu's disease (TD) does not seem to be accidental and does not seem to modify the natural course of the 2 pathologies. The granulomatous character of the inflammatory infiltrate of the vascular wall appears to be the result of the pro-inflammatory effect of several cytokines, such as TNF and the IL-6, -8, -12 and -18 common to both entities. The literature reports more than 40 cases of Takayasu's disease associated with Crohn's disease. However, the association of these two pathologies with autoimmune thyroiditis has never been described before in the literature. In a case hospitalized in the gastroenterology department of the Mohammed VI University Hospital in Marrakech, of a woman with autoimmune thyroiditis treated by total thyroidectomy and hormone replacement therapy, Crohn's disease and Takayasu's disease for which she was treated by antiTNF treatment and the evolution was marked by a good clinical response.

Takayasu's disease: an underdiagnosed entity in Sub-Saharan Africa. Report of five Gabonese cases

RésuméLa maladie de Takayasu est une vascularite affectant de façon préférentielle l'aorte et ses principales branches. Mycobacterium tuberculosis peut notamment être un facteur déclenchant du développement de la maladie de Takayasu par une réaction d'hypersensibilité. Le Maghreb et l'Afrique du Sud cumulent le plus grand nombre d'observations africaines, alors qu'entre les deux, en Afrique subsaharienne, les données parcellaires de la maladie font penser que la prévalence de la maladie est probablement sous-estimée/sous-diagnostiquée. Nous en rapportons 5 observations gabonaises.