Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, and Hacettepe University Vasculitis Center, Ankara, Turkey.
Hacettepe University Vasculitis Center, and Division of Paediatric Rheumatology, Department of Paediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Clin Exp Rheumatol. 2021 Mar-Apr;39 Suppl 129(2):32-38. doi: 10.55563/clinexprheumatol/kr357t. Epub 2020 Sep 16.
Takayasu's arteritis (TAK) is a chronic vasculitis, affecting predominantly the aorta and/or its major branches. The aim of this study was to compare the differences between childhood and adult onset TAK.
We retrospectively evaluated 179 TAK patients followed between August 2005 and July 2019. Demographic characteristics, laboratory features, disease activity, echocardiographic data at diagnosis and treatment regimens in the disease course were compared between the paediatric and adult onset patients.
Twenty-five paediatric-onset (<18 years of age at diagnosis) and 154 adult-onset patients (≥18 years of age at diagnosis) were enrolled. The mean age at diagnosis for children and adults were 13.6±4 and 35.6±13, respectively. Paediatric onset TAK patients had more intense inflammation at the time of diagnosis reflected in their clinical findings. Acute phase reactants were high in all paediatric patients and significantly higher in patients with paediatric-onset TAK (p=0.006 and p=0.005, respectively). Abdominal predominant disease was more common in the paediatric group, in contrast, focal disease and aortic arch predominant disease were more common in the adult group. Ascending aortic dilatation, left ventricular hypertrophy and moderate-severe aortic insufficiency were more frequent in echocardiography findings of paediatric onset TAK patients. In comorbidities, hypertension was more common in paediatric TAK patients during follow-up, whereas cerebrovascular disease was more common in adult patients.
Our paediatric onset TAK patients presented with a more severe inflammation and more widespread vascular involvement. Multicentre studies from different geographic areas are needed to verify our observation and understand the underlying causes.
Takayasu 动脉炎（TAK）是一种主要影响主动脉及其主要分支的慢性血管炎。本研究旨在比较儿童和成人发病 TAK 之间的差异。
我们回顾性评估了 2005 年 8 月至 2019 年 7 月期间随访的 179 例 TAK 患者。比较了儿科和成人发病患者的人口统计学特征、实验室特征、疾病活动度、诊断时的超声心动图数据和疾病过程中的治疗方案。
纳入 25 例儿童发病（<18 岁）和 154 例成人发病（≥18 岁）患者。儿童和成人的诊断时年龄分别为 13.6±4 岁和 35.6±13 岁。儿科发病 TAK 患者在诊断时炎症更剧烈，表现在其临床表现中。所有儿科患者的急性期反应物均升高，儿童发病 TAK 患者的升高更为显著（分别为 p=0.006 和 p=0.005）。腹部为主型疾病在儿科组更为常见，而局灶型疾病和主动脉弓型疾病在成人组更为常见。升主动脉扩张、左心室肥厚和中重度主动脉瓣关闭不全在儿科发病 TAK 患者的超声心动图表现中更为常见。在合并症方面，高血压在儿科 TAK 患者随访期间更为常见，而脑血管疾病在成人患者中更为常见。
我们的儿科发病 TAK 患者表现出更严重的炎症和更广泛的血管受累。需要来自不同地理区域的多中心研究来验证我们的观察结果并了解其潜在原因。
