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Revista Portuguesa de Cardiologia :... Mar 2015Takayasu arteritis is a large vessel vasculitis with various clinical presentations depending on the territories affected. We report the case of a 47-year-old woman who...
Takayasu arteritis is a large vessel vasculitis with various clinical presentations depending on the territories affected. We report the case of a 47-year-old woman who was diagnosed with Takayasu arteritis following rapid progression of coronary disease. The condition evolved rapidly under corticosteroid therapy, with formation of new arterial stenoses within the carotid and splanchnic circulations. Disease remission was achieved with cyclophosphamide pulses and percutaneous angioplasty of the affected vessels was performed.
Topics: Female; Humans; Middle Aged; Takayasu Arteritis
PubMed: 25727751
DOI: 10.1016/j.repc.2014.11.002 -
Journal of the American College of... Aug 2022Inflammatory aortitis is most often caused by large vessel vasculitis (LVV), including giant cell arteritis, Takayasu's arteritis, immunoglobulin G4-related aortitis,... (Review)
Review
Inflammatory aortitis is most often caused by large vessel vasculitis (LVV), including giant cell arteritis, Takayasu's arteritis, immunoglobulin G4-related aortitis, and isolated aortitis. There are distinct differences in the clinical presentation, imaging findings, and natural history of LVV that are important for the cardiovascular provider to know. If possible, histopathologic specimens should be obtained to aide in accurate diagnosis and management of LVV. In most cases, corticosteroids are utilized in the acute phase, with the addition of steroid-sparing agents to achieve disease remission while sparing corticosteroid toxic effects. Endovascular and surgical procedures have been described with success but should be delayed until disease control is achieved whenever possible. Long-term management should include regular follow-up with rheumatology and surveillance imaging for sequelae of LVV.
Topics: Aorta; Aortitis; Giant Cell Arteritis; Humans; Immunoglobulin G; Takayasu Arteritis
PubMed: 35981827
DOI: 10.1016/j.jacc.2022.05.046 -
Scientific Reports Mar 2021Recent studies have provided evidence of a close link between specific microbiota and inflammatory disorders. While the vessel wall microbiota has been recently...
Recent studies have provided evidence of a close link between specific microbiota and inflammatory disorders. While the vessel wall microbiota has been recently described in large vessel vasculitis (LVV) and controls, the blood microbiome in these diseases has not been previously reported (LVV). We aimed to analyse the blood microbiome profile of LVV patients (Takayasu's arteritis [TAK], giant cell arteritis [GCA]) and healthy blood donors (HD). We studied the blood samples of 13 patients with TAK (20 samples), 9 patients with GCA (11 samples) and 15 HD patients. We assessed the blood microbiome profile by sequencing the 16S rDNA blood bacterial DNA. We used linear discriminant analysis (LDA) coupled with linear discriminant effect size measurement (LEfSe) to investigate the differences in the blood microbiome profile between TAK and GCA patients. An increase in the levels of Clostridia, Cytophagia and Deltaproteobacteria and a decrease in Bacilli at the class level were found in TAK patients compared with HD patients (LDA > 2, p < 0.05). Active TAK patients had significantly lower levels of Staphylococcus compared with inactive TAK patients. Samples of GCA patients had an increased abundance of Rhodococcus and an unidentified member of the Cytophagaceae family. Microbiota of TAK compared with GCA patients was found to show higher levels of Candidatus Aquiluna and Cloacibacterium (LDA > 2; p < 0.05). Differences highlighted in the blood microbiome were also associated with a shift of bacterial predicted metabolic functions in TAK in comparison with HD. Similar results were also found in patients with active versus inactive TAK. In conclusion, patients with TAK were found to present a specific blood microbiome profile in comparison with healthy donors and GCA subjects. Significant changes in the blood microbiome profiles of TAK patients were associated with specific metabolic functions.
Topics: Aged; Aged, 80 and over; Biomarkers; Computational Biology; Disease Susceptibility; Female; Giant Cell Arteritis; Humans; Male; Metagenome; Metagenomics; Microbiota; Middle Aged; Sepsis; Takayasu Arteritis
PubMed: 33723291
DOI: 10.1038/s41598-021-84725-5 -
Journal of Neuro-ophthalmology : the... Mar 2016
Topics: Giant Cell Arteritis; Humans; Temporal Arteries
PubMed: 26709692
DOI: 10.1097/WNO.0000000000000343 -
Rheumatic Diseases Clinics of North... Feb 2023Takayasu's arteritis (TAK) and giant cell arteritis (GCA) are the 2 most common primary large vessel vasculitides (LVV). They share common vascular targets, clinical... (Review)
Review
Takayasu's arteritis (TAK) and giant cell arteritis (GCA) are the 2 most common primary large vessel vasculitides (LVV). They share common vascular targets, clinical presentations, and histopathology, but target a strikingly different patient demographic. While GCA predominantly affects elderly people of northern European ancestry, TAK preferentially targets young women of Asian heritage. Cardiovascular diseases (CVD), including ischemic heart disease, cerebrovascular disease, aortic disease, and thromboses, are significantly increased in LVV. In this review, we will compare and contrast the issue of CVD in patients with TAK and GCA, with respect to prevalence, risk factors, and mechanisms of events to gain an understanding of the relative contributions of active vasculitis, vascular damage, and accelerated atherosclerosis. Controversies and possible mitigation strategies will be discussed.
Topics: Humans; Female; Aged; Cardiovascular Diseases; Giant Cell Arteritis; Takayasu Arteritis; Atherosclerosis; Risk Factors
PubMed: 36424028
DOI: 10.1016/j.rdc.2022.08.004 -
Medicina Clinica Jun 2017
Topics: Aged; Giant Cell Arteritis; Humans; Male; Necrosis; Scalp
PubMed: 27650211
DOI: 10.1016/j.medcli.2016.07.023 -
Clinical and Experimental Rheumatology 2017Takayasu's arteritis (TAK) is a rare, chronic, large-vessel vasculitis (LVV) that predominantly affects aorta, its major branches and the pulmonary arteries. Recent... (Review)
Review
Takayasu's arteritis (TAK) is a rare, chronic, large-vessel vasculitis (LVV) that predominantly affects aorta, its major branches and the pulmonary arteries. Recent controversial issues in the diagnosis, disease assessment and prognosis in TAK are discussed in this review. In recent years, conventional angiography, the standard method for the initial diagnosis, seems to have been replaced by the new imaging modalities, such as MRI and 18F-FDG-PET. Less invasive techniques (CT/MRI) are now suggested first, compared to conventional angiography, and MRI is preferable to CT with less contrast load/radiation. Ultrasound is useful for carotid assessment, but being a user-dependent technique, imaging of deeper vessels (subclavian and aorta) are not reliable. 18F-FDG-PET is useful especially in patients with no vascular symptoms/signs, fever of unknown origin or unexplained acute-phase response. MRI and 18F-FDG-PET are also promising for the assessment of disease activity. New tools for disease assessment such as Indian Takayasu Arteritis Score (ITAS2010) aim to better characterise and quantify disease activity. Prognosis is recently possibly getting better with lower mortality, but a substantial damage is present even in early cases. There is a clear need to develop a validated set of outcome measures to be used in clinical trials of TAK. The OMERACT Vasculitis Working Group has taken on this task, finished a Delphi exercise with experts and aims to develop a core set of outcomes for LVV.
Topics: Biomarkers; Biopsy; Diagnosis, Differential; Humans; Predictive Value of Tests; Prognosis; Reproducibility of Results; Severity of Illness Index; Takayasu Arteritis
PubMed: 28375833
DOI: No ID Found -
The Journal of Rheumatology Oct 2017
Topics: Arteritis; Computed Tomography Angiography; Coronary Angiography; Coronary Vessels; Humans; Immunoglobulin G4-Related Disease; Male; Middle Aged
PubMed: 28966170
DOI: 10.3899/jrheum.170262 -
La Revue de Medecine Interne Apr 2016The imaging is essential for the diagnosis of large vessels arteritis, in order to assess the persistent inflammation of arterial lesions, to evaluate the treatment... (Review)
Review
The imaging is essential for the diagnosis of large vessels arteritis, in order to assess the persistent inflammation of arterial lesions, to evaluate the treatment response and search the vascular complications. In patients with giant cell arteritis (GCA), the aortitis could be suspected in 2 situations: in the presence of general constitutional symptoms or systematic screening of aortitis in patient with confirmed GCA. The frequency of aortitis varies according to the imaging method and could be detected in 40 % of patients with computed tomography and MRI, and approximately in 60 % with FDG-PET/CT. The clinical and prognostic value of systematic detection of aortitis during the GCA remains to be determined. In Takayasu arteritis, imaging is performed to diagnose the large vessels vasculitis, to determine the arterial lesions extension to assess the persistent inflammation of arterial lesions. The persistent vascular inflammation should be suspected in the presence of arterial thickness, of arterial enhancement, a parietal edema and increased arterial FDG uptake (>liver). However, the value of these parameters and the threshold remain to be determined. Thus, the value of FDG-PET/CT and MRI and of parameters used to characterize the persistent arterial inflammation should be further studied.
Topics: Diagnosis, Differential; Diagnostic Imaging; Giant Cell Arteritis; Humans; Predictive Value of Tests; Prognosis; Treatment Outcome
PubMed: 26880245
DOI: 10.1016/j.revmed.2015.10.353 -
Journal of the American Society of... Sep 2021Renal involvement in ANCA-associated vasculitis (AAV) is associated with poor outcomes. The clinical significance of arteritis of the small kidney arteries has not been...
BACKGROUND
Renal involvement in ANCA-associated vasculitis (AAV) is associated with poor outcomes. The clinical significance of arteritis of the small kidney arteries has not been evaluated in detail.
METHODS
In a multicenter cohort of patients with AAV and renal involvement, we sought to describe the clinicopathologic characteristics of patients with AAV who had renal arteritis at diagnosis, and to retrospectively analyze their prognostic value.
RESULTS
We included 251 patients diagnosed with AAV and renal involvement between 2000 and 2019, including 34 patients (13.5%) with arteritis. Patients with AAV-associated arteritis were older, and had a more pronounced inflammatory syndrome compared with patients without arteritis; they also had significantly lower renal survival (=0.01). In multivariable analysis, the ANCA renal risk score, age at diagnosis, history of diabetes mellitus, and arteritis on index kidney biopsy were independently associated with ESKD. The addition of the arteritis status significantly improved the discrimination of the ANCA renal risk score, with a concordance index (C-index) of 0.77 for the ANCA renal risk score alone, versus a C-index of 0.80 for the ANCA renal risk score plus arteritis status (=0.008); ESKD-free survival was significantly worse for patients with an arteritis involving small arteries who were classified as having low or moderate risk, according to the ANCA renal risk score. In two external validation cohorts, we confirmed the incidence and phenotype of this AAV subtype.
CONCLUSIONS
Our findings suggest AAV with renal arteritis represents a different subtype of AAV with specific clinical and histologic characteristics. The prognostic contribution of the arteritis status remains to be prospectively confirmed.
Topics: Aged; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Arteritis; Disease-Free Survival; Female; France; Humans; Kidney Failure, Chronic; Male; Middle Aged; Prognosis; Renal Artery; Retrospective Studies; Risk Factors
PubMed: 34155059
DOI: 10.1681/ASN.2020071074