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Ultrasound examination of the right carotid artery in (A) longitudinal and (B) cross-section: marked echogenic mural thickening (arrowheads).
Source publication
Takayasu arteritis is a devastating vasculitis of the aorta and its major branches. The clinical manifestations in paediatric patients are less specific than in adults: in children the disease presents with fever, arthralgias and hypertension. Intramural inflammation results in narrowing of the blood vessel lumen and therefore hypoperfusion of the...
Context in source publication
Context 1
... the common carotids, 95% for the brachio- cephalic trunks and 97% for the vertebral arteries [97]. Sonography reveals thickening of affected vessel walls, occlusion and dilatation. Sonography might help to estab- lish early disease of TA in a pre-stenotic phase in the extracranial vessels [96]. Alterations in flow velocity can be determined ( Fig. 2A and B). The method is inexpensive and without radiation exposure. Limitations include the investigator-dependent quality of the examination. 18FDG-PET is an imaging technique used to assess the increased glucose metabolism in inflammatory cells. Some recent studies have concluded that there is a pos- sible role for 18FDG-PET as a screening ...
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Citations
... Since it is not a common vasculitis, clinicians often do not consider TA in the differential diagnosis, and the diagnosis can take even years after the first onset of symptoms. 8 In this paper, we offer a compelling clinical scenario that describes the development of ANE as a result of SARS-CoV-2 ...
... Although Takayasu arteritis is frequently seen in young women, it can also affect young infants and adolescents 2 . Takayasu arteritis in childhood is rare, with only 2.6/1 000 000 of childhood-onset Takayasu arteritis reported in literature until now 3 . Features are variable depending on the stage of disease. ...
... Although TAK is frequently seen in young women, it can also affect young infants and adolescents [2]. TAK in childhood is rare, with only a few cases of childhood-onset TAK reported in literature until now [3]. ...
Background
Takayasu arteritis is a rare and chronic granulomatous vasculitis that affects the large vessels. Takayasu arteritis targets the aorta and its branches and is still of unknown etiology. It often affects female patients under 50 years of age. A relationship between Takayasu arteritis and tuberculosis has been suggested for a long time.
Case presentation
We report a severe case of Takayasu arteritis in a 10-year-old Tunisian child revealed by renovascular hypertension with concomitant pulmonary tuberculosis.
Conclusions
Our patient is among only a few cases of Takayasu arteritis published worldwide affecting young infants and adolescents, which underlines the strong relationship between Takayasu arteritis and tuberculosis.
... Results of small case series also suggest that mycophenolate mofetil or anti-TNF-a therapy may be beneficial in select patients. Anti-IL-6 therapy with tocilizumab has shown promising results in a small case series of children with TA. 7 Antihypertensive medications are often necessary to control blood pressure caused by renovascular disease. Although ACE inhibitors have potency in reducing organ remodelling and proteinuria, it would be detrimental to use it here in a case of unilateral renal ischemia since this is an ongoing disease which has a propensity to involve the contralateral side in future. ...
Childhood Takayasu arteritis is one of the most common vasculitis in paediatric age group. It predominantly involves the greater vessels such as aorta and its branches, leading to granulomatous inflammation. The process of inflammation gives rise to the symptoms based on thrombotic or aneurysmal phenomena. This is a case report of a 11-year-old girl diagnosed in an urban tertiary care centre in India with childhood Takayasu arteritis. The said child had first presented with non-specific symptoms such as leg ache, back ache and fever. Over the course of illness, the child developed hypertension and had also suffered from PRES (posterior reversible encephalopathy syndrome). Clinical examination was consistent with Takayasu arteritis, however with predominant medium-sized vessel involvement on imaging. Since this is a relatively atypical presentation, it was mandatory to rule out other causes of medium-vessel arteritis, especially DADA2 (deficiency of ADA2).
... High blood pressure is reported to be the most common symptom in these two age populations [2,11]. Studies carried out in children are not numerous, Brunner and al [12] published a meta-analysis (nine studies and 241 patients) which noted the clinical symptoms and particularities of TA in children and adolescents, the therapeutic possibilities and its prognostic factors. Juvenile TA has been described at any age, even in 6-month-old infants [12], with an average age at disease onset estimated at 12 years [13]. ...
... Studies carried out in children are not numerous, Brunner and al [12] published a meta-analysis (nine studies and 241 patients) which noted the clinical symptoms and particularities of TA in children and adolescents, the therapeutic possibilities and its prognostic factors. Juvenile TA has been described at any age, even in 6-month-old infants [12], with an average age at disease onset estimated at 12 years [13]. Its exact incidence is not known, although most studies in Europe and North America estimated an overall incidence between 1 and 2.6/1.000.000 ...
Takayasus Arteritis (TA) is a rare granulomatous vasculitis affecting large vessels, mainly the aorta and its branches as well as the pulmonary arteries
... It occurs in the pediatric population and adults [4,5]. The symptoms are diverse and the disease can begin with non-specific manifestations such as fatigue, myalgia, arthralgia, fever [6]. ...
... Cardiovascular manifestations such as claudication of upper or lower limbs, as well as a difference in systolic arterial pressure of both arms or both legs, noise in some of the affected arteries and others are typical [4][5][6][7][8]. Cutaneous and/or neurological manifestations may also be present [9,10]. ...
Systemic vasculitis is a group of heterogeneous diseases characterized by inflammation of the vascular wall. They can be primary or arise in the context of another disease. Blood vessels of different sizes are affected, being mainly divided into small, medium and large vessels. Takayasu's arteritis is a vasculitis of the large blood vessels, most often affecting the aorta and its branches, subclavian arteries, iliac, femoral arteries and others. The presented clinical case concerns a woman with non-specific symptoms - low fever, sweating, weight loss, easy fatigue. After excluding an infectious genesis of the complaints, a diagnosis of Takayasu's Arteritis was made in the early phase of the disease as a result of Positron emission tomography. Corticosteroid and immunosuppressive therapy was started. When conducting a control PET, 20 months after the start of the therapy, a significant regression to absence of the findings from the imaging study was observed.
... 4 Takayasu arteritis affects mainly young females in the second and third decades of life, mainly the aortic arch and its primary branches. 5 Takayasu arteritis is characterised by granulomatous inflammation of the vessel wall, leading to occlusion of the vessel wall. It can be represented with claudication, fever, arthralgia, and weight loss. ...
Takayasu arteritis, also called pulseless disease, is the chronic inflammation of the vessels, mainly the aorta and large vessels. It mainly affects females more than males with the ratio of 2.15:1 and in the second and third decade of life. Mechanism may be transmural fibrous thickening of the arterial walls. Takayasu’s is characterized by granulomatous inflammation of the vessel wall, leading to occlusion of the vessel wall. It is represented with claudication, fever, arthralgia. Clinical features are chest pain, vascular bruits, Hypertension. Investigation is based on angiography and CT scan. Medical treatment prednisolone is the first line agent 1mg/kg/day maximum dose is 60mg/day with gradual tapering as per European league against rheumatism guidelines, methotrexate and azathioprine are for inducing remission of arterial lesions, tumour necrosis factor-a antagonists, anti-IL-6 receptor monoclonal antibody like tocilizumab. Surgical treatment is angioplasty and stenting renal artery stenosis but less invasive and safest method is percutaneous transluminal angioplasty (PTA). Takayasu arteritis might be associated with Tuberculosis, yet, the relationship and mechanism are not clearly understood. Here we report a case of Takayasu arteritis associated with tuberculosis.
... TAK is a non-specific large-vessel vasculitis, often granulomatous, with obstructive or dilatory lesions in the aorta and its major branches, pulmonary arteries, and coronary arteries. The male-to-female ratio was 1:5 to 9. The age at onset of TAK is generally between 10 and 40 years [2][3][4], but patients with elderly onset have recently been reported [1,3,[5][6][7][8][9][10]. The prevalence varies by race, and this disease is more common in Asians [10]. ...
... The male-to-female ratio was 1:5 to 9. The age at onset of TAK is generally between 10 and 40 years [2][3][4], but patients with elderly onset have recently been reported [1,3,[5][6][7][8][9][10]. The prevalence varies by race, and this disease is more common in Asians [10]. GCA, on the other hand, affects the aorta and its major branches, particularly the subclavian, carotid, and vertebral arteries. ...
Objective:
We conducted a nationwide epidemiological study to estimate the number of patients with Takayasu arteritis (TAK) and giant cell arteritis (GCA) in Japan and to describe the clinical characteristics of these patients.
Methods:
The first survey was designed to estimate the number of patients with TAK and GCA who were treated at medical institutions in Japan in 2017. The second survey was designed to collect data on the clinical characteristics of the patients who were reported in the first survey.
Results:
Of the 3,495 institutions selected for the first survey, 1,960 (56.1%) responded. The number of patients with clinically diagnosed TAK and GCA was estimated to be 5,320 (95% confidence interval [CI], 4,810-5,820) and 3,200 (95% CI, 2,830-3,570), respectively. Aortic regurgitation was reported in 35% of patients with TAK, and eye-related comorbidities were observed in 30.4% of patients with GCA. The common carotid and internal carotid arteries were the most frequently involved in patients with TAK (62.7%). Subclavian artery lesions and thoracic or abdominal aorta lesions were reported in 31% and 42.6% of patients with GCA, respectively.
Conclusions:
The number of patients with TAK and GCA was estimated simultaneously, and significant differences in clinical characteristics were observed between the two diseases.
... 13 Estudos descrevendo características clínicas de crianças e adolescentes com AT relataram uma alta prevalência de cefaleia, febre, perda de peso, e insuficiência cardíaca, bem como elevada proporção de hipertensão renovascular. [14][15][16][17][18] Em descrições angiográficas, o achado mais prevalente é o envolvimento de toda a aorta, além de progressões clínica e de imagem mesmo em pacientes com doença bem controlada. [17][18][19][20] Embora escassos, estudos têm sugerido que o curso da AT varia entre pacientes jovens e adultos. ...
Background:
Few studies have assessed elderly patients with Takayasu's arteritis (TAK).
Objectives:
To evaluate the progression of TAK in different age groups and its possible effects on drug treatment and disease activity.
Methods:
This cross-sectional and retrospective cohort study included 66 TAK patients. Patients were interviewed and data of the 12 preceding months were collected from electronic medical records. The patients were divided into four quartiles according to current age and compared for clinical and laboratory data, treatment, comorbidities, disease status, and functional status. Statistical significance was set at p<0.05.
Results:
The groups were Q1(22-36 years, n=16), Q2(37-42 years, n=18), Q3(43-49 years, n=17), and Q4(51-66 years, n=15). The frequency of patients with disease activity, fatigue, comorbidities and vascular impairments, and the TAK disease extent index were also comparable between the groups. With age, disease duration was longer (p=0.001), fewer patients used prednisone (Q1:43.8%, Q2:33.3%, Q3:11.8%, and Q4:6.7%; p=0.049) and immunosuppressive drugs [Q1:100.0%, Q2:66.7%, Q3:58.8%, and Q4:46.7%; Q1 versus Q3 (p=0.043), and Q1 versus Q4 (p=0.005) in post-hoc analyses], and patients had greater functional status impairment (Q2 versus Q3, p=0.003). In addition, the levels of disease damage, new TAK symptoms, and complications in the preceding 12 months were not different between the groups.
Conclusions:
Older patients with TAK require minimal drug treatment, and have greater impairment of functional status, which may be attributed to aging-related factors.
... Criteria for the diagnosis of TA are clinical or refer to angiographic changes consistent with TA [10]. Complications from the arterial inflammation include stenosis, thrombosis, and arterial wall thickening that may result in end organ dysfunction. ...
Objectives
Takayasu arteritis (TA) is a large vessel vasculitis rarely reported in children and infants. Most articles on pediatric TA have not focused on infants. We present the largest case series of infantile TA aiming to identify its demographic and clinical characteristics and compare them with existing data on older children.
Methods
We conducted an international multicentre retrospective cohort study. Epidemiological and clinical data were collected from patients’ charts from six rheumatology centers. All patients met both the EULAR/PReS 2008 criteria and the 1990 ACR/EULAR criteria and were diagnosed with TA at age <5 years.
Results
Twelve patients were included (50% female). Median age of symptom onset was 11 months, with a diagnostic delay of 4 months. The most common symptoms at presentation were hypertension, blood pressure differences between limbs, and fever. The most commonly involved arteries were the abdominal aorta and renal artery. Medications included steroids, conventional and biological disease-modifying antirheumatic drugs, and other immunosuppressive therapies. Half of the patients received biologic agents of which infliximab had the highest complete remission rate (40%). Other medications resulting in complete remission were cyclophosphamide (40%) and methotrexate (38%). Invasive procedures were required for 58% of patients. The most common complications were cardiac (50%), stroke (42%), and serious infections (33%). No patients died.
Conclusions
This study presents the largest series of infantile TA. Compared with other reported series on older children, infants with TA have more severe disease and were more likely to receive biologic agents, develop complications, and require invasive interventions.
