Clinical Characteristics of Takayasu's Arteritis

ABSTRACT

BACKGROUND AND OBJECTIVES: akayasu's arteritis is a disease of unknown etiology which has recently been reported to be a systemic disease. This is a prospective study of the clinical features and angiographic findings of Takayasu's arteritis from a single center. SUBJECTS AND METHODS: orty five patients were diagnosed as Takayasu's arteritis according to the Numano's diagnostic criteria, where patients satisfying at least one criterion from elevated ESR or CRP, arterial wall enhancement at MRA or CT angiography, or carotid tenderness are categorized into the active group. A disease duration of one year was used to define the division of the disease into either acute or chronic. Ueno's and Numano's classifications obtained through various imaging studies, were used. RESULTS: t the time of diagnosis, 60% of patients were in the active stage while 40% were in inactive stage. Levels of ESR, CRP and fibrinogen were found to differ significantly according to disease activity. The most common type of Takayasu's arteritis was type III according to the Ueno's classification, and type V according to the Numano's. The left subclavian artery was involved most frequently (78.5%). The most commonly involved segment of the aorta was the abdominal aorta (64.4%). Mean systolic blood pressure of the right arm in the renal artery stenosis group was 156+/-39 mmHg, which was significantly higher than that in the group without renal artery stenosis (113+/-46 mmHg) (p=0.005). ESR and CRP were correlated with aortic signal intensity on contrast-enhanced MR imaging (ESR;r=0.685, p=0.007/CRP;r=0.596, p=0.041). CONCLUSION: akayasu's arteritis is a disease of unknown causes, especially among young female patients, and exhibits nonspecific and various symptoms. ESR and CRP remain as valuable indicators of disease activity. The MR enhancement intensity of the arterial wall shows a positive correlation with both ESR and CRP level and it therefore may be correlated to disease activity and represent a useful diagnostic indicator.