scholarly journals POS0810 PULMONARY FINDINGS ON HIGH-RESOLUTION COMPUTED TOMOGRAPHY IN TAKAYASU ARTERITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 657.2-658
Author(s):  
X. Kong ◽  
J. Zhang ◽  
J. Lin ◽  
P. LV ◽  
H. Chen ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Takayasu Arteritis ◽  
Heart Function ◽  
Takayasu’S Arteritis ◽  
Normal Lung ◽  
Takayasu's Arteritis ◽  
High Resolution Computed Tomography ◽  
Pulmonary Infarction ◽  
Pulmonary Lesions ◽  
Pleural Thickening

Background:Takayasu arteritis (TA) is a chronic granulomatous large-vessel vasculitis most commonly seen in women under 50 years of age[1]. The pulmonary arteries are less often involved, with the frequency of involvement varying widely between countries (from 4% to >50%) [2–5]. Respiratory symptoms or signs and pulmonary imaging findings in TA have not been fully investigated [6–7].Objectives:This study aimed to describe pulmonary high-resolution computed tomography (HRCT) findings in TA and to determine possible causes.Methods:A total of 243 TA patients were enrolled from a prospective cohort after excluding 260 patients with other pulmonary disorders or incomplete data. Clinical data including symptoms, lab results, imaging information were collected. Pulmonary HRCT were interpreted by two radiologist who were blinded to patients’ clinical information. Abnormal pulmonary features were recorded as nodules, stripe opacity (linear opacity), patchy opacity, ground-glass opacity, pleural thickening, pleural effusion, pulmonary infarction, mosaic attenuation, pulmonary bronchiectasis, pulmonary oedema. After evaluation, patients were divided into two groups: those with normal lung HRCT and those with abnormal lung HRCT. Clinical characteristics were compared between groups and binary logistic regression analysis was applied to identify potential risk factors for the lung lesions. Follow-up HRCT (obtained in 64 patients) was analysed to study changes in pulmonary lesions after at least 6 months’ treatment.Results:Of the 243 patients, 107 (44.0%) had normal lung HRCT while 136 (56.0%) had abnormal lung HRCT, including stripe opacity (60.3%), nodules (44.9%), patchy opacity (25.0%), pleural thickening (15.4%), pleural effusion (10.3%), ground-glass opacity (8.1%), pulmonary infarction (6.6%), mosaic attenuation (4.4%), bronchiectasis (3.7%), and pulmonary oedema (2.2%). Patients with abnormal HRCT were significantly more likely to have type II arterial involvement (25% vs. 12.2%, P = 0.04), pulmonary arterial involvement (PAI; 21.3% vs. 5.6%, P < 0.001), pulmonary hypertension (20.6% vs. 8.4%, P = 0.01), and abnormal heart function (27.9% vs. 7.6%, P < 0.001). Logistic regression analysis demonstrated that PAI (OR = 3.0, 95% CI= 1.1-8.4, P=0.03), worsened heart function (OR = 2.7, 95% CI = 1.1-6.6, P=0.03), and age (OR = 1.1, 95% CI = 1.0-1.1, P<0.01) were associated with presence of pulmonary lesions. Pulmonary infarction, pleural effusion, and patchy opacities improved partially after treatment.Conclusion:Pulmonary lesions are not rare in patients with TA. Age, PAI, and worsened heart function are potential risk factors for presence of pulmonary lesions in TA.References:[1]Jennette JC, Falk RJ, Bacon PA, et al. 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013;65:1-11.[2]Kong X, Ma L, Wu L, et al. Evaluation of clinical measurements and development of new diagnostic criteria for Takayasu arteritis in a Chinese population. Clin Exp Rheumatol. 2015; 33(2 Suppl 89): S-48-55.[3]Nooshin D, Neda P, Shahdokht S, Ali J. Ten-year Investigation of Clinical, Laboratory and Radiologic Manifestations and Complications in Patients with Takayasu’s Arteritis in Three University Hospitals. Malays J Med Sci. 2013; 20(3):44-50.[4]Bicakcigil M, Aksu K, Kamali S, et al. Takayasu’s arteritis in Turkey – clinical and angiographic features of 248 patients. Clin Exp Rheumatol. 2009; 27(1 Suppl 52):S59-64.[5]Kechaou M, Frigui M, Ben Hmida M, Bahloul Z. Takayasu arteritis in Southern Tunisia a study of 29 patients. Presse Med. 2009; 38(10):1410-4.[6]Dou JB, Gong JN, Ma ZH, Kuang TG, Yang YH. The analysis of the clinical records diagnosed as Takayasu’s arteritis with pulmonary vascular involvement. Zhonghua Jie He Hu Xi Za Zhi. 2016; 39(8):603-7.[7]Nd Perera G, C Jayasinghe A, D Dias L, Kulatunga A. Bronchiectasis and hoarseness of voice in takayasu arteritis: a rare presentation. BMC Res Notes. 2012; 5:447.Disclosure of Interests:None declared

Pulmonary findings on high-resolution computed tomography in Takayasu arteritis

Rheumatology ◽  
2021 ◽  
Author(s):  
Xiufang Kong ◽  
Jing Zhang ◽  
Jiang Lin ◽  
Peng Lv ◽  
Huiyong Chen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Pleural Effusion ◽  
Heart Function ◽  
Normal Lung ◽  
High Resolution Computed Tomography ◽  
Pulmonary Infarction ◽  
Pulmonary Lesions ◽  
Arterial Involvement

Abstract Objective This study aimed to describe pulmonary high-resolution computed tomography (HRCT) findings in Takayasu arteritis (TA) and to determine possible causes. Methods A total of 243 TA patients were enrolled from a prospective cohort after excluding patients with other pulmonary disorders or incomplete data. Patients were divided into two groups: those with normal lung HRCT and those with abnormal lung HRCT. Clinical characteristics were compared between groups and binary logistic regression analysis was applied to identify possible causes of the lung lesions. Follow-up HRCT (obtained in 64 patients) was analysed to study changes in pulmonary lesions after treatment. Results Of the 243 patients, 107 (44.0%) had normal lung HRCT while 136 (56.0%) had abnormal lung HRCT, including stripe opacity (60.3%), nodules (44.9%), patchy opacity (25.0%), pleural thickening (15.4%), pleural effusion (10.3%), ground-glass opacity (8.1%), pulmonary infarction (6.6%), mosaic attenuation (4.4%), bronchiectasis (3.7%), and pulmonary oedema (2.2%). Patients with abnormal HRCT were significantly more likely to have type II arterial involvement (25% vs. 12.2%, P = 0.04), pulmonary arterial involvement (PAI; 21.3% vs. 5.6%, P &lt; 0.001), pulmonary hypertension (20.6% vs. 8.4%, P = 0.01), and abnormal heart function (27.9% vs. 7.6%, P &lt; 0.001). Logistic regression analysis demonstrated that PAI, worsened heart function, and age were associated with presence of pulmonary lesions. Pulmonary infarction, pleural effusion, and patchy opacities improved partially after treatment. Conclusion Pulmonary lesions are not rare in patients with TA. Age, PAI, and worsened heart function are potential risk factors for presence of pulmonary lesions in TA.

scholarly journals Unusual etiology of stroke in young adults: think of Takayasu’s arteritis

2021 ◽  
Vol 8 (4) ◽  
pp. 594
Author(s):  
Vikram Aglave ◽  
Shashank Nagendra ◽  
Pawan T. Ojha ◽  
Kamlesh A. Jagiasi ◽  
Sumit Kharat ◽  
...  
Keyword(s):  
Young Adults ◽  
Takayasu Arteritis ◽  
Hemorrhagic Stroke ◽  
Takayasu’S Arteritis ◽  
Sedimentation Rates ◽  
Takayasu's Arteritis ◽  
Stroke In Young Adults ◽  
Erythrocyte Sedimentation ◽  
Erythrocyte Sedimentation Rates ◽  
Stroke In Young

Takayasu arteritis is an uncommon inflammatory disease of vessels that preferentially affects the aorta and its major branches. It can be a potential cause of stroke in young adults. Current study included 7 patients aged between 18 to 48 years. Each patient had varying presentations of stroke with Takayasu’s arteritis along with other neurological symptoms. Four of the 7 patients presented with ischemic strokes, one with hemorrhagic stroke, one with TIAs and one with syncopal attacks. All the patients had elevated erythrocyte sedimentation rates. Five of the seven patients were treated with steroids and methotrexate. Two were treated with azathioprine and steroids. Antiplatelets were given for those patients who had strokes and TIAs. Our cases demonstrate that Takayasu arteritis can present with varying presentations including stroke. Thus, it is important to consider Takayasu’s arteritis as an unusual etiology of stroke especially in young adults.

Pulmonary Infarction as the Initial Manifestation of Takayasu's Arteritis

2006 ◽  
Vol 45 (11) ◽  
pp. 725-728 ◽  
Author(s):  
Tomomi Nakamura ◽  
Shinichiro Hayashi ◽  
Mami Fukuoka ◽  
Naoko Sueoka ◽  
Kohei Nagasawa
Keyword(s):  
Takayasu’S Arteritis ◽  
Takayasu's Arteritis ◽  
Pulmonary Infarction ◽  
Initial Manifestation

scholarly journals Pulmonary infarction revealing pulmonary Takayasu's arteritis

1998 ◽  
Vol 92 (7) ◽  
pp. 969-971 ◽  
Author(s):  
G. Devouassoux ◽  
C. Pison ◽  
P. Witmeyer ◽  
F. Tony ◽  
M. Coulomb ◽  
...  
Keyword(s):  
Takayasu’S Arteritis ◽  
Takayasu's Arteritis ◽  
Pulmonary Infarction

scholarly journals Steroid Resistant Takayasu Arteritis

2013 ◽  
Vol 33 (2) ◽  
pp. 144-146 ◽  
Author(s):  
Malay Kumar Dasgupta ◽  
Sabyasachi Das ◽  
Debasree Guha
Keyword(s):  
Takayasu Arteritis ◽  
Inflammatory Disease ◽  
Takayasu’S Arteritis ◽  
Pulmonary Arteries ◽  
Chronic Inflammatory Disease ◽  
Takayasu's Arteritis ◽  
Steroid Resistant ◽  
Disease Expression

Takayasu’s arteritis (TA), a chronic inflammatory disease affecting the aorta, its branches and the pulmonary arteries has become increasingly recognized as a worldwide entity, with a variable spectrum of disease expression. Here in a case of paediatric Takayasu arteritis affecting purely the arch of aorta and it’s branches that was steroid resistant. DOI: http://dx.doi.org/10.3126/jnps.v33i2.7113   J Nepal Paediatr Soc. 2013; 33(2):144-146

scholarly journals Takayasu’s Arteritis with Subcutaneous Nodules in a 4-year -old Child: A Case Report

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Sunil Kumar Das ◽  
Aakrit Dahal ◽  
Nikhil Shrestha ◽  
Sajal Tnawanasu ◽  
Subash Sharma
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Acute Phase ◽  
Takayasu Arteritis ◽  
Oral Corticosteroid ◽  
Takayasu’S Arteritis ◽  
Subcutaneous Nodule ◽  
Takayasu's Arteritis ◽  
Acute Phase Reactants ◽  
Subcutaneous Nodules

A 4-year-old girl who presented with pain in the abdomen, subcutaneous nodule, fever and was later diagnosed with Takayasu arteritis . Oral corticosteroid and methotrexate were started. Childhood TA should be kept in differential diagnosis when presented with subcutaneous nodules and increased acute phase reactants.

scholarly journals AB0490 CIRCULATING REGULATORY T CELLS WERE ABSOLUTELY DECREASED IN TAKAYASU’S ARTERITIS PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1542.1-1543
Author(s):  
W. Jia ◽  
J. Xie ◽  
X. Wang ◽  
C. Gao ◽  
G. Liu ◽  
...  
Keyword(s):  
Takayasu Arteritis ◽  
Peripheral Blood ◽  
Th17 Cells ◽  
Takayasu’S Arteritis ◽  
Absolute Number ◽  
Treg Cells ◽  
Healthy Controls ◽  
Takayasu's Arteritis ◽  
Tnf Α ◽  
The Absolute

Background:Takayasu arteritis (TA) refers to chronic progressive non-specific inflammation that involves the aorta and its main branches, causing stenosis and occlusion of arteries in different parts, and ischemic manifestations in the corresponding parts. A variety of immune dysfunctions are involved in the occurrence and development of TA(1)Recent studies have shown that Th17/Treg imbalance plays an important role in the pathogenesis of Takayasu’s arteritis, in which T help 17 cells (Th17) cells are up-regulated in TA patients(2). Th17 cells are closely related to Treg cells during differentiation. There are few studies on the expression level of CD4+CD25+FOX3+T lymphocyte (Treg) cells. This study aims to study the clinical significance of Treg cell expression in peripheral blood of patients with Takayasu’s arteritis.Objectives:To analyze the levels of circulating lymphocyte subsets and serum cytokines in patients with takayasu arteritis (TA), and explore the relationship between their changes and TA disease activity.Methods:A total of 46 TA patients and 43 gender-age-matched healthy controls were enrolled. According to the NIH standard, 30 patients were in active disease. Flow cytometry was used to detect the absolute numbers and ratios of Th1, Th2, Th17 and Treg cells in peripheral blood of all subjects. Magnetic bead-based multiplex immunoassay was used to detect cytokines and statistical analysis was performed.Results:Compared with the healthy controls, the absolute number and proportion of peripheral Treg cells of TA patients significantly decreased while those of Th17 cells increased significantly, leading to the increased ratio of Th17 / Treg. Compared with the inactive group, the TA active group had significantly increased IL-6 and TNF-α, and there was no significant difference in the expression of Th17 cells and Treg cells.Conclusion:In peripheral blood of TA patients, Treg cells decreased, while Th17 cells increased as compared with healthay controls, leading to an imbalance between Th17 and Treg cells. The levels of IL-6 and TNF-α were related to disease activity.References:[1]Russo, R.A.G. and M.M. Katsicas, Takayasu Arteritis. Front Pediatr, 2018. 6: p. 265.[2]Misra, D.P., S. Chaurasia, and R. Misra. Increased Circulating Th17 Cells, Serum IL-17A, and IL-23 in Takayasu Arteritis. Autoimmune Dis, 2016. 2016: p. 7841718.Figure 1.Characteristics of the absolute numbers and proportions of Th1cells,Th2cells,Th17 cells and CD4Treg cells in the PB of patients with TA.(A-C)The levels of Th17 cells and the ratio of Th1/Treg,Th2/Treg,Th17/Treg in PB were significantly increased in patients with TA (n=46). The absolute number and the proportion of CD4Treg cells were significantly decreased in TA(n=46). (D-F) The absolute number of Th2 cells and ratio of Th2/Treg in PB were significantly decreased in active patients with TA (n=30).Neither the absolute number nor proporation of Th1, Th17 and Treg cells was altered significantly between active TA patients(n=30) and inactive TA patients(n=16).*P<0.05; **P<0.001. P<0.05 was considered statistically significant.TA,takayasu arteritis;PB peripheral blood;Tregs, regulatory Tcells.Figure 2.Characteristics of serum concentrations of cytokine (including IL-6, IL-10, IL-17 and TNF-α) between active TA patients(n=30) and inactive TA patients(n=16).(A,D)In terms of cytokines, the concentration of IL-6 and TNF-α was significantly up-regulated,(B,C)but no significant changes in IL-10, and IL-17 were found.*P<0.05; **P<0.001. P < 0.05 was considered statistically significant.Disclosure of Interests:None declared

scholarly journals Pregnancy in a rare case of Takayasu’s arteritis: a case report

2019 ◽  
Vol 8 (6) ◽  
pp. 2563
Author(s):  
Kushal Shah ◽  
Vaishali Korde Nayak
Keyword(s):  
Takayasu Arteritis ◽  
Takayasu’S Arteritis ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Reproductive Age ◽  
Uncontrolled Hypertension ◽  
Care Hospital ◽  
Takayasu's Arteritis ◽  
Asian Origin ◽  
Reproductive Age Group

In Takayasu’s arteritis is a rare, chronic idiopathic vasculitis affecting aorta and its major branches, commonly seen in young women of Asian origin. Incidence is 2.6 cases/million/year. Female of reproductive age group are commonly affected. A 32-year female G3A2 with known case of Takayasu arteritis wanted to continue this pregnancy under tremandous social pressure and came for antenatal care at tertiary care hospital. As the pregnancy advanced, she developed uncontrolled hypertension and severe IUGR. At 30 weeks of gestation, elective LSCS had to be done in view of reduced fetal blood flow and severe growth restriction. She delivered male baby of 1 kg which was shifted to NICU. Patient required cardiac intensive care unit for first 48 hrs and later shifted to ward. Postoperative period was uneventful, and patient could be discharged on 8th day. Baby received intensive NICU care and discharged after 1 month with 2 kg weight. Pregnancy with takayasu arteritis requires a multipronged management from gynaecologist, cardiologist, cardiac anaesthetist and neonatologist for favourable maternal and fetal outcome.

scholarly journals Takayasu’s arteritis in pregnancy: a rare case report from BJGMC and Sassoon Hospital Pune, Maharashtra, India

2017 ◽  
Vol 6 (8) ◽  
pp. 3703
Author(s):  
Amisha Dogra ◽  
Uma N. Wankhede
Keyword(s):  
Takayasu Arteritis ◽  
Takayasu’S Arteritis ◽  
Post Partum ◽  
Fetal Outcome ◽  
Takayasu's Arteritis ◽  
Pulseless Disease ◽  
Child Bearing ◽  
Healthy Female ◽  
Rare Case Report ◽  
Female Baby

Takayasu’s arteritis is a chronic idiopathic vasculitis affecting aorta and its primary branches, commonly seen in young women of Asian or oriental descent during child bearing age. Incidence is 2.6 cases/million/year. It affects females in the reproductive years accounting for almost 80% of the cases. A 34 year female G2P1L1 with 9 months of amenorrhea with previous LSCS known case of takayasu arteritis, epilepsy with right side hemiparesis with aphasia. She proceeded to have elective LSCS with ventouse delivery under epidural anaesthesia and delivered alive healthy female baby weight 2.4 kg and patient was transferred to intensive care unit for observation for 48 hrs. patients intrapartum post partum period was uneventful and discharged after 1month with cardiology fitness. Pregnancy with takayasu arteritis (pulseless disease) requires a multidisciplinary management from gynaecologist, cardiologist, neurologist for favourable maternal and fetal outcome.

scholarly journals AB0487 TAKAYASU’S ARTERITIS: RECOGNIZING AN OLD ENEMY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1541.2-1541
Author(s):  
F. Torres ◽  
D. Jaramillo Arroyave ◽  
C. Muñoz ◽  
L. Hernandez ◽  
G. Vásquez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Retrospective Study ◽  
Physical Examination ◽  
Takayasu Arteritis ◽  
Takayasu’S Arteritis ◽  
Pulmonary Arteries ◽  
Secondary Source ◽  
Type I ◽  
Takayasu's Arteritis ◽  
Initial Symptoms

Background:Takayasu’s arteritis (AT) is a systemic vasculitis that affects large vessels, mainly the aorta, its branches and the pulmonary arteries. There are few data on their behavior in our region.Objectives:to describe the clinical and angiographic characteristics and outcomes of a group of patients with AT.Methods:a cross-sectional, retrospective study based on a secondary source taken from two high complexity hospitals in Medellin - Colombia between August 2011 and December 2018.Results:medical records of 41 patients were evaluated, 87.5% met the 1990 ACR criteria of AT. The majority were women (95.1%), with a median age at the time of diagnosis of 22 years (IR 52), 11 patients (26.8%) were over 40 years old at debut. The median delay in diagnosis was 12 months (IR: 167). Systemic symptoms included general malaise (29.3%), weight loss (29.3%) and fever (19.5%); the main vascular manifestations were hypertension and blood pressure difference (61%), headache (39%), upper limb claudication (31.7%), dyspnea (29.3%), angina (26.8%) and carotidinia (22%). Most frequent findings on physical examination were pulse absence or decrease (78%) and subclavian murmur (53.7%). ESR and CRP were found high in 85.3% and 22%, respectively. Angiographic studies revealed stenosis or occlusion in multiple arterial territories, being the stenosis of the left subclavian artery the most frequent lesion (68.3%), followed by the involvement of the abdominal aorta (58.5%) and thoracic (51%). The distribution according to Hata-Numano classification was: type V (58.5%), type I (17.1%) and type IIa (7.3%), indicating complex vascular lesions and associated serious complications. Abnormalities of the renal arteries, pulmonary arteries involvement, and aortic insufficiency were present in 39%, 14.6%, and 7.3% respectively. Seventy-five percent of patients had active disease, glucocorticoids were the main treatment in 90.2% of the cases, used isolated (2.4%) or in combination with other immunosuppressants (87.8%), including methotrexate (75.6%), azathioprine (26.8%) and cyclophosphamide (14.6%); vascular interventions were performed in 11 patients (26.8%). Most relevant vascular complications were renovascular hypertension (26.8%), stroke (19.5%), chronic kidney disease (19.5%) and chronic heart failure (17.1%). From the clinical point of view, our findings were similar to those shown in series from Brazil, Japan, and Turkey. Contrary to what was reported in other series, carotidinia was a finding that occurred in almost a quarter of our patients (23%) and maybe one of the initial symptoms of the disease. The findings of the vascular physical examination are similar to those reported by the IRAVAS group, where the asymmetry of the pulses was most frequent, followed by the presence of murmurs and the difference in blood pressure, claudication being less frequent in the upper and lower limbs.Conclusion:patients in this series are characterized by having an extensive disease partly due to a late diagnosis, with a high percentage of complications associated with vascular stenotic compromise, which generates morbidity and impact on the quality of life.References:[1]Sato EI, et al. Takayasu arteritis. Treatment and prognosis in a university center in Brazil, Int J Cardiol. 2000; 75 Suppl 1: S163-6.[2]Arnaud L, et al. Takayasu arteritis in France: a single-center retrospective study of 82 cases comparing white, North African, and black patients. Medicine (Baltimore). 2010; 89(1): 1-17.Disclosure of Interests: :None declared

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