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Takayasu's arteritis

Jing Li, Hongchao Li, Fei Sun, Zhe Chen, Yunjiao Yang, Jiuliang Zhao, Mengtao Li, Xinping Tian, Xiaofeng Zeng
OBJECTIVE: To understand the characteristics of heart involvement in Chinese patients with Takayasu arteritis (TA). METHODS: The medical charts of 411 patients with TA (325 women, 86 men) were retrospectively reviewed. The comparison of clinical manifestations was carried out between the patients with TA with (n = 164) and without (n = 247) heart involvement. RESULTS: The median age at disease onset was 23.0 years (18.0-30.0) in 411 patients with TA, and 23...
August 15, 2017: Journal of Rheumatology
Tristan Mirault, Henri Guillet, Emmanuel Messas
Takayasu arteritis (TAK) is a vasculitis of the large arteries. The arterial wall, target of the immune reaction, is composed of vascular dendritic cells, endothelial cells, vascular smooth muscle cells and fibroblasts, which engage in an interaction with T cells and macrophages to, ultimately, cause luminal stenosis or aneurysmal wall damage of the vessel. A multitude of cytokines have been identified to increase in case of TAK and to be linked to disease activity. A better understanding of the physiopathological pathways and mechanisms involved, might enable a more tailored therapeutic approach in TAK...
August 10, 2017: La Presse Médicale
Aswin M Nair, Ruchika Goel, M Hindhumati, K Jayakanthan, J Visalakshi, George Joseph, Sumita Danda, Debashish Danda
Assessment of disease activity in Takayasu arteritis (TA) is challenging. We aimed to study utility of serum amyloid A (SAA) to assess disease activity and its association with SAA gene polymorphisms, if any, in our TA patients. Serum of 99 consecutive adult TA patients and 40 healthy controls were assayed for SAA. Depending on the ITAS2010 and ITAS-CRP score, patients were designated as having active disease if ITAS2010 ≥ 2 or ITAS-CRP ≥ 3 and stable disease if ITAS2010 = 0 or ITAS-CRP is ≤1. Clinical ITAS of 0 with raised inflammatory markers scoring a ITAS-CRP of 2 was considered as indeterminate for disease activity assessment...
August 11, 2017: Rheumatology International
Hak Ju Kim, Jae-Woong Choi, Ho Young Hwang, Hyuk Ahn
BACKGROUND: We evaluated the operative outcomes of an extra-anatomic bypass from the ascending aorta to the abdominal aorta in patients with type II or III Takayasu arteritis (TA) with mid-aortic syndrome. METHODS: From 1988 to 2014, 8 patients with type II (n=2) or III (n=6) TA underwent an ascending aorta to abdominal aorta bypass. The mean patient age was 43.5±12.2 years and the mean peak pressure gradient between the upper and lower extremities was 54.8±39...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
Catherine Chapelon-Abric, David Saadoun, Isabelle Marie, Cloé Comarmond, Anne Claire Desbois, Fanny Domont, Léa Savey, Patrice Cacoub
OBJECTIVE: To describe the features of exceptional coexisting Takayasu arteritis (TA) and sarcoidosis, two conditions of unknown cause associated with a common immunologic pattern. METHODS: We report seven cases of concomitant sarcoidosis-Takayasu or Takayasu-like vasculitis, observed in two referral centers between 1995 and 2015. RESULTS: All patients were female. The mean age at sarcoidosis diagnosis and TA diagnosis was 36 and 37 years, respectively...
August 8, 2017: International Journal of Rheumatic Diseases
Gokhan Keser, Kenan Aksu
Management of Takayasu arteritis (TAK) is challenging mostly due to difficulties in assessing actual disease activity. The rational of medical treatment is to suppress both vascular and systemic inflammation with appropriate systemic immunosuppression, including corticosteroids and conventional immunosuppressive (IS) agents. In case of refractory disease activity, biologic agents such as TNF inhibitors and tocilizumab may be tried. In selected cases, endovascular interventions and surgical procedures may be indicated and should be performed during inactive disease...
July 31, 2017: La Presse Médicale
Matthew J Koster, Kenneth J Warrington
The two main variants of large vessel vasculitis include Takayasu arteritis and giant cell arteritis. While these two conditions have historically been considered different conditions, recent evidence questions whether they are a spectrum of the same disease. Classification criteria are limited in distinguishing between cases with phenotypic overlap. The limitations of the current criteria and directions of future research are reviewed.
July 31, 2017: La Presse Médicale
Xiufang Kong, Lili Ma, Zongfei Ji, Zhihui Dong, Zhigang Zhang, Jun Hou, Si Zhang, Lingying Ma, Lindi Jiang
OBJECTIVES: This study aimed to clarify potential mechanism of IL-6 involved in adventitial fibrosis via adventitial fibroblast in Takayasu arteritis (TAK). METHODS: Immunohistochemistry and double-labelled immunofluorescence were performed on vascular tissue from patients with TAK and controls. Human aorta adventitial fibroblast (AAF) was cultured and stimulated with interleukine 6 (IL-6)/IL-6 receptor (IL-6R). Real-time PCR, western blot, enzyme-linked immunosorbent assays, chromatin immunoprecipitation (ChIP) and reporter assay were conducted in vitro experiments to determine effect of IL-6/IL-6R on AAF...
July 6, 2017: Clinical and Experimental Rheumatology
Wala M Alali, Saeed A Alahmari, Yahya S Alhebaishi, Seham A Alrashidi
We present an uncommon case of a 48-year-old female patient with symptomatic presentation of a severe aortic regurgitation with aneurysm of the ascending aorta and progressive dyspnea. Detailed investigation of laboratory tests and imaging identified Takayasu's arteritis (TA) as the underlying etiology. Computed tomography scan revealed complete occlusion of the right carotid artery as well as stenosis at the origins of left subclavian and vertebral arteries. In addition, cardiac magnetic resonance angiogram showed aneurysm at the proximal segment of right subclavian artery...
August 2017: Saudi Medical Journal
Atsushi Okada, Hiroyuki Takahama, Masatsune Ogura, Yoshiaki Morita, Junichi Konma, Shuzo Yoshida, Shigeki Makino, Seiji Takashio, Makoto Amaki, Takahiro Ohara, Takuya Hasegawa, Yasuo Sugano, Hideaki Kanzaki, Mariko Harada-Shiba, Hatsue Ishibashi-Ueda, Satoshi Yasuda, Toshiaki Hanafusa, Toshihisa Anzai
Although left ventricular (LV) systolic dysfunction in patients suffering from Takayasu arteritis (TA) has been reported, little is known regarding the development of heart failure in these patients. We report a novel finding of active TA and familial hypercholesterolaemia presenting with severe LV dysfunction through multimodality assessments of LV systolic dysfunction.
July 31, 2017: ESC Heart Failure
Adrien Mirouse, Patrice Cacoub, Anne Claire Desbois, Cloé Comarmond, Christian Pagnoux, David Saadoun
Treatment of systemic vasculitis is based on glucocorticoids (GC) in association with immunosuppressive therapy. There are still unmet needs, including earlier onset of response, more targeted therapies, reduction of relapse-risk and decrease of long-term GC and classic immunosuppressants toxicities. Areas covered: In this review, we discuss investigational drugs in early phase clinical trials for induction of remission in vasculitis. We focus on ANCA-associated vasculitis, Behçet's disease, giant cell arteritis, Takayasu arteritis, and cryoglobulinemic vasculitis...
August 4, 2017: Expert Opinion on Investigational Drugs
Gary W Procop, Charis Eng, Alison Clifford, Alexandra Villa-Forte, Leonard H Calabrese, Eric Roselli, Lars Svensson, Douglas Johnston, Gosta Pettersson, Edward Soltesz, Lisa Lystad, Julian D Perry, Alexander Blandford, Deborah A Wilson, Gary S Hoffman
OBJECTIVE: It is controversial whether microorganisms play a role in the pathogenesis of large and medium vessel vasculitides (eg, giant cell arteritis [GCA], Takayasu arteritis [TAK] and focal idiopathic aortitis [FIA]). Recent studies have reported the presence of Varicella Zoster Virus (VZV) within formalin-fixed, paraffin-embedded temporal arteries and aortas of about three-quarters or more of patients with these conditions, and in a minority of controls. In a prospective study, we sought to confirm these findings using DNA extracted from vessels that were harvested under surgically aseptic conditions and snap frozen...
2017: Pathogens & Immunity
Enrico Tombetti, Justin C Mason
Arterial injury with subsequent remodelling and predisposition to arterial stenosis and/or dilation are the hallmarks of Takayasu arteritis. The degree of arterial damage closely aligns with prognosis and therefore its prevention is the predominant aim of therapy. Non-invasive imaging has greatly improved our ability to identify the extent and severity of disease and to monitor its progress. However, many questions remain concerning the optimal use of individual modalities at different stages of disease. Imaging methods for the quantification of arterial damage are lacking...
July 27, 2017: La Presse Médicale
Fatma Alibaz-Oner, Antoine G Sreih, Peter A Merkel, Haner Direskeneli
Patient-reported outcomes (PROs) are assessment tools coming directly from patients about their feelings, perceptions, health-related functions, and treatment effects without interpretation by health-care providers. There is a global interest for more "patient-centered care" and PROs in rheumatology. Assessment of disease impact through patient-reported outcome (PRO) measures is a key element for clinical care and clinical research in Takayasu's arteritis (TAK). Currently there are no disease-specific PRO measures to assess quality of life for patients with TAK...
July 26, 2017: La Presse Médicale
Paul Renauer, Amr H Sawalha
Takayasu arteritis (TAK) is a rare systemic vasculitis that is characterized by granulomatous inflammation of the aorta and its major branches. The cellular and biochemical processes involved in the pathogenesis of TAK are beginning to be elucidated, and implicate both cell and antibody-mediated autoimmune mechanisms. In addition, the underlying etiology to TAK may be explained, at least in part, by a complex genetic contribution. The most well-recognized genetic susceptibility locus for the disease is the classical HLA allele, HLA-B*52, which has been confirmed in several ethnicities...
July 26, 2017: La Presse Médicale
Fatos Onen, Nurullah Akkoc
Takayasu arteritis (TA), a granulomatous large vessel vasculitis involves mostly the aorta and its proximal branches and occurs most commonly in young females. The data on the epidemiology of TA is limited, probably due to the rarity of the disease. Although the disease has a worldwide distribution, it is generally thought to be much more common among Asian populations. The incidences of TA were estimated to be 1-2 per million in Japan and 2.2 per million in Kuwait. Recent epidemiologic studies suggest that TA is being increasingly recognized in Europe with reported incidence estimates varying from 0...
July 26, 2017: La Presse Médicale
Brandon T Garland, Manfred Boehm, Peter C Grayson, Cynthia St Hilaire, Alessandra Brofferio, Benjamin W Starnes
Takayasu arteritis is a large-vessel vasculitis that often results in pulselessness due to fibrotic stenoses. Whereas minor calcification is sometimes seen with Takayasu arteritis, it rarely causes stenosis. Extensive calcification resulting in malperfusion is exceedingly rare and has been attributed to disorders in calcium trafficking in a chronic inflammatory state. We report an unusual case of rapidly progressive and extensive aortic calcification in the setting of Takayasu arteritis.
December 2016: J Vasc Surg Cases Innov Tech
H M M T B Herath, S P Pahalagamage, D Withana, Sunethra Senanayake
BACKGROUND: Takayasu arteritis is a rare, chronic large vessel vasculitis involving the aorta and its primary branches. As the disease progresses, the active inflammation of large vessels leads to dilation, narrowing and occlusion of the arteries. Arterial dissection is due to separation of the layers of the arterial wall resulting in a false lumen, where blood seeps into the vessel wall. Neurological sequelae of intracranial arterial dissection results from cerebral ischemia due to thromboembolism and hypo perfusion...
July 25, 2017: BMC Cardiovascular Disorders
Michal Kirshenbaum, Michal J Simchen, Ramat Gan
OBJECTIVE: To investigate the clinical features of pregnancy in women with Takayasu's arteritis managed in a tertiary medical center and review the literature in order to establish the course and recommended follow up and treatment for these pregnancies. MATERIALS AND METHODS: Retrospective analysis of 20 pregnancies in 6 women with Takayasu's arteritis. Patients were recruited from the high risk pregnancy clinics at Sheba Medical Center, where follow up included strict control of blood pressure and treatment of obstetric and disease related complications...
July 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
Reetu A John, Shyamkumar N Keshava, Debashish Danda
OBJECTIVES: To correlate magnetic resonance imaging (MRI) assessment of disease activity in patients with Takayasu's arteritis with the Indian Takayasu's activity score (ITAS). DESIGN, MATERIALS AND METHODS: We prospectively assessed 20 patients with Takayasu's arteritis from November 2010 to September 2011. RESULTS: We found a statistically significant association between MRI assessment of disease activity and ITAS with a P-value of 0.01...
July 2017: International Journal of Rheumatic Diseases
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