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Rheumatology International

, Volume 38, Issue 12, pp 2263–2270 | Cite as

Clinical presentation, treatment and outcome of Takayasu’s arteritis in southern Chinese: a multicenter retrospective study

  • Stella Pui Yan WongEmail author
  • Chi Chiu Mok
  • Chak Sing Lau
  • Man Lung Yip
  • Lai Shan Tam
  • King Yee Ying
  • Woon Leung Ng
  • Kam Hung Ng
  • Moon Ho Leung
  • Tsz Yan Lee
  • Chi Hung To
  • Ka Lai Lee
  • Man Choi Wan
  • Ka Lung Yu
  • Priscilla Ching Han Wong
  • Chi Keung Sung
  • Kwok Fai Lee
  • Emily Wai Lin Kun
  • for the Hong Kong Takayasu’s arteritis study group
Cohort Studies
  • 113 Downloads

Abstract

To study the clinical presentation, treatment and outcome of southern Chinese patients with Takayasu’s arteritis (TA). This is a retrospective chart review study of 78 patients managed in 14 public hospitals in Hong Kong between the years 2000 and 2010. Patients were identified from the hospital registry using the ICD-10 diagnostic code of the disease. The classification of TA was based on the American College of Rheumatology (ACR) or modified Ichikawa’s criteria. Demographic data, clinical presentation, angiographic findings, pattern of vascular involvement (Numano’s classification), treatment and outcome of these patients were presented. 78 patients were studied (82% women, age at presentation 34.2 ± 14 years). The estimated point prevalence of TA was 11/million population. The commonest initial manifestations were hypertension (62%) and vascular ischemic symptoms (38%). Systemic symptoms occurred in nine (12%) patients only. The proportion of patients fulfilling the angiographic subtypes of the Numano’s classification was: types I (13%), IIa (4%), IIb (12%), III (12%), IV (20%) and V (39%), respectively. Thirty-two patients (41%) were treated with high-dose glucocorticoids (GCs) and 22 patients (28%) received additional non-GC immunosuppressive drugs. Vascular complications occurred in 26 (33%) patients and revascularization surgery was performed in 23(29%) patients. Three (4%) patients died of vascular complication at a median of 8 years after disease onset. TA is rare in southern Chinese patients of Hong Kong. Most patients present with ischemic symptoms during the stenotic phase of the disease. Although mortality is low, a significant proportion of patients developed vascular stenosis that required surgical interventions. More awareness of TA as a differential diagnosis of non-specific systemic symptoms with elevated inflammatory markers in younger patients is needed for earlier diagnosis.

Keywords

Autoimmune Aortitis Vasculitis Large vessel Prognosis 

Notes

Author contributions

Study design: Dr. MCC, Dr. KWL. Data collection and interpretation: Dr. WPYS, Dr. MCC, Dr. LCS, Dr. YML, Dr. LST, Dr. YKY, Dr. NWL, Dr. NKH, Dr. LMH, Dr. LTY, Dr. TCH, Dr. LKL, Dr. WMC, Dr. YKL, Dr. WCHP, Dr. SCK, Dr. LKF, Dr. KWL. Statistical analyses of data: Dr. WPYS, Dr. MCC.

Funding

Funding of this project and writing assistance: Nil.

Compliance with ethical standards

Ethical approval

New Territories West Cluster Research and Ethics Committee, Hospital Authority, Hong Kong (date of approval: 29-8-2011; NTWC/CREC/967/11). All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

All authors did not have any conflict of interests to be declared.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Stella Pui Yan Wong
    • 1
    Email author
  • Chi Chiu Mok
    • 2
  • Chak Sing Lau
    • 3
  • Man Lung Yip
    • 4
  • Lai Shan Tam
    • 5
  • King Yee Ying
    • 6
  • Woon Leung Ng
    • 7
  • Kam Hung Ng
    • 8
  • Moon Ho Leung
    • 9
  • Tsz Yan Lee
    • 9
  • Chi Hung To
    • 10
  • Ka Lai Lee
    • 11
  • Man Choi Wan
    • 12
  • Ka Lung Yu
    • 2
  • Priscilla Ching Han Wong
    • 5
  • Chi Keung Sung
    • 13
  • Kwok Fai Lee
    • 14
  • Emily Wai Lin Kun
    • 13
  • for the Hong Kong Takayasu’s arteritis study group
  1. 1.Department of MedicineTseung Kwan O HospitalHong Kong SARChina
  2. 2.Department of MedicineTuen Mun HospitalHong Kong SARChina
  3. 3.Department of MedicineThe University of Hong KongHong Kong SARChina
  4. 4.Tung Wah Groups of Hospital Integrated Diagnostic and Medical CentreHong Kong SARChina
  5. 5.Department of Medicine & Therapeutics Faculty of MedicineThe Chinese University of Hong KongShatinChina
  6. 6.Department of Medicine and GeriatricsPrincess Margaret HospitalHong Kong SARChina
  7. 7.Department of Medicine and GeriatricsUnited Christian HospitalHong Kong SARChina
  8. 8.Department of Medicine and GeriatricsCaritas Medical CentreHong Kong SARChina
  9. 9.Department of Medicine, Queen Elizabeth HospitalHong Kong SARChina
  10. 10.Department of Medicine, Pok Oi HospitalHong Kong SARChina
  11. 11.Department of Medicine, Pamela Youde Nethersole Eastern HospitalHong Kong SARChina
  12. 12.Department of Medicine, Ruttonjee HospitalHong Kong SARChina
  13. 13.Department of Medicine & Geriatrics, Tai Po HospitalHong Kong SARChina
  14. 14.Department of Medicine, Yan Chai HospitalHong Kong SARChina

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