Clinical characteristics and long-term outcome of Takayasu arteritis in Iran: a multicentre study

Authors: AIDA MALEK MAHDAVI, NADEREH RASHTCHIZADEH, HADISEH KAVANDI, MEHRZAD HAJIALILO, SOUSAN KOLAHI, MOHAMMAD-REZA NAKHJAVANI, ALI-ASGHAR EBRAHIMI, SEYEDMOSTAFA SEYEDMARDANI, MANSOUR SALESI, MOHSEN SOROUSH, ALIREZA KHABBAZI

Abstract: Background/aim: This study aimed to evaluate the demographic, clinical, angiographic and prognostic characteristics of Takayasu arteritis (TA) in Iran. Materials and methods: A total of 75 patients with TA based on the American College of Rheumatology 1990 criteria for TA classification referred to the Rheumatology Centres, were followed-up from 1989 to 2019. Demographic, clinical, angiographic and prognostic characteristics were collected at baseline and last visit. Results: The mean age was 31.9 ± 9.8 years at the disease onset. Female to male ratio was 14. The median latency in diagnosis was 24 months. Pulse discrepancy in the arms, blood pressure discrepancy in the arms, limb claudication, hypertension and constitutional symptoms were the most common clinical features. The most common angiographic type at the time of diagnosis was Type I (42.7%). The most frequent arterial lesion was stenosis (89.4%). Subclavian, carotid and aortic arteries were the most commonly involved arteries. New lesions developed in 28.6% of patients during the 5.25-year follow-up. Vasculitis-induced chronic damage was observed in all patients. Disease activity decreased and vascular damage remained stable throughout the follow-up period. Conclusions: The clinical features and angiographic type of TA in Iran are different from most Asian countries. Differences in angiographic and clinical features may lead to delayed diagnosis. The issue of delay in diagnosis should create awareness among health care providers that TA is not a very rare disease in Iranians and failure to pay attention to warning symptoms may delay the diagnosis.

Keywords: Takayasu arteritis, Birmingham Vasculitis Activity Score (BVAS), Indian Takayasu Clinical Activity Score (ITAS), Vasculitis Damage Index (VDI), outcome, remission, Iran.

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