Ten-year Investigation of Clinical, Laboratory and Radiologic Manifestations and Complications in Patients with Takayasu’s Arteritis in Three University Hospitals

Background: Takayasu arteritis is a condition of unknown aetiology that affects the aorta and its primary branches. The disease has been primarily recognised and described in Asia. The aims of this study were to identify the main clinical, laboratory, and angiographic features of Takayasu arteritis in Iranian patients over a 10 year period from 2000 to 2010.
Methods: Data were obtained from angiographic and medical records of patients treated at Shahid-Rajai, Taleghani, and Loghman Hospitals during the above-mentioned time period. The criteria for definitions and findings were those proposed by the American College of Rheumatology.
Results: A total of 15 patients were identified. The median age at presentation was 36 years and 73.3% of patients were females. Fever was the most common presentation. According to “modified” National Institute of Health criteria, 44.7% of patients were in the acute phase of disease with systemic symptoms such as fever, weight loss, and elevated C-reactive protein (CRP) levels. Immunological markers such as antinuclear antibodies (ANA) and antineutrophil cytoplasmic antibodies (C-ANCA) were absent. The tuberculin test result was positive in 40% of the patients. Vascular bruit was present in 86.7% and hypertension was detected in 53.3% with 13.3% having associated renal artery stenosis. The angiographic manifestations were classified as; type I, cervicobrachial type (26.6%); type II, thoracoabdominal type (20.0%); type III, peripheral type (6.6%); and type IV, generalised type (46.7%). Coronary arteries were involved in three cases, pulmonary in two and renal in two.
Conclusion: Based on our findings, the most common clinical, laboratory and angiographic findings were fever, increased erythrocyte sedimentation rate (ESR) and stenosis, respectively. Because of dangerous consequences of this disease, attention to fever and increased ESR, especially in young women may be helpful for physicians to prevent diagnosis delay.

Keywords
Takayasu arteritis; systemic vasculitis; arteriography; claudication; tuberculosis