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New Takayasu Arteritis Patient Features
Study Questions:
What are the clinical features of newly diagnosed Japanese patients with Takayasu arteritis (TA)?
Methods:
Between 2001 and 2011, newly diagnosed patients with TA in Japan were evaluated for clinical signs and symptoms. Symptoms and angiographic lesions were compared by sex and age.
Results:
A total of 1,372 patients newly diagnosed with TA were 83.8% female. The median age of onset was 35 years, but was higher among male versus female patients (43.5 vs. 34 years, p < 0.001). The most frequent complaints (in order) were systemic manifestations, head/neck complaints, and upper extremity findings. Men had more frequent hypertension than head/neck complaints. Approximately 85% of patients had vascular involvement of the aortic arch or major branches. Many young women had localized lesions, whereas men had more extensive aortic lesions or aneurysms with complications. Localized abdominal lesions were also more common in male patients, with an age at onset >40 years, as compared with other age-sex groups.
Conclusions:
The authors concluded that male patients represent approximately 16% of all new TA patients, and that men experienced more severe vascular disease.
Perspective:
TA is traditionally described as a younger, female-predominant disease (90%) that affects the aorta and its major branches. However, this study suggests that an increase in diagnosis of male and older patients is changing the overall TA population in Japan. In particular, male patients and older patients had lesions throughout the aortic bed, not limited to the head/neck and aortic arch. This study of Japanese patients suggests that onset of disease after age 40 is common enough to not exclude TA, despite giant cell arteritis being a more common diagnosis in this age group.
Keywords: Aneurysm, Angiography, Aorta, Thoracic, Giant Cell Arteritis, Hypertension, Peripheral Arterial Disease, Primary Prevention, Takayasu Arteritis, Vascular Diseases, Vasculitis
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