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Takayasu arteritis in children and young indians
1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India.
International Journal of Cardiology
|September 12, 2000
Summary
This study on young Takayasu arteritis (TA) patients found hypertension and renal artery involvement are common. The clinical profile of pediatric TA mirrors that of adult cases.
Area of Science:
- Pediatric Rheumatology
- Cardiovascular Medicine
- Vascular Inflammation
Background:
- Takayasu arteritis (TA) is a rare, chronic inflammatory disease affecting large arteries, primarily the aorta and its branches.
- Pediatric-onset TA presents unique challenges in diagnosis and management due to its rarity and potential for severe complications in growing individuals.
Purpose of the Study:
- To describe the clinical characteristics, angiographic findings, treatment, and outcomes of patients with Takayasu arteritis diagnosed before 18 years of age.
- To compare the presentation and course of pediatric TA with that reported in adult populations.
Main Methods:
- Retrospective analysis of 24 patients diagnosed with Takayasu arteritis before age 18 over a 20-year period (1978-1998).
- Data collection included demographics, clinical presentation, diagnostic imaging (angiography), treatment interventions, and follow-up outcomes.
- Key parameters analyzed were age at presentation, sex distribution, presenting symptoms, cardiac involvement, aortic and branch artery involvement, therapeutic strategies, and mortality.
Main Results:
- The study included 24 patients (20 females, 4 males; M:F ratio 1:5), with a mean age of 14 years at presentation.
- Hypertension was the most common presentation (83%), followed by congestive heart failure (16%) and left ventricular hypertrophy (54%).
- Angiography revealed abdominal aorta involvement in 71% and renal artery involvement in 75% of cases. Treatment included antihypertensives, antitubercular drugs, and steroids; two patients underwent successful renal angioplasty. Two deaths occurred due to renal and heart failure.
Conclusions:
- The clinical and angiographic profile of Takayasu arteritis in young patients is largely similar to that observed in adults.
- Early diagnosis and comprehensive management, including blood pressure control and addressing vascular inflammation, are crucial for improving outcomes in pediatric TA.
- Renal artery involvement is a significant feature, highlighting the importance of vigilant monitoring and timely intervention, such as angioplasty, to prevent complications like renal failure.