Clinical presentation, treatment and outcome of Takayasu’s arteritis in southern Chinese: a multicenter retrospective study
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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.
KeywordsAutoimmune Aortitis Vasculitis Large vessel Prognosis
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 of this project and writing assistance: Nil.
Compliance with ethical standards
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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