Takayasu arteritis in children.

Area of Science:

• Pediatric Rheumatology
• Vascular Inflammation
• Autoimmune Diseases

Background:

• Takayasu arteritis (TA) is a rare large vessel vasculitis predominantly affecting young women.
• While typically diagnosed in the second and third decades of life, TA can manifest in childhood, even in patients as young as 24 months.
• Understanding pediatric TA is critical due to its potential for severe vascular complications.

Purpose of the Study:

• To describe four pediatric cases of Takayasu arteritis.
• To summarize key findings from published studies on childhood TA.
• To highlight clinical presentation, diagnostic features, and treatment outcomes in pediatric TA.

Main Methods:

• Retrospective case series of four children diagnosed with TA.
• Review of relevant published literature on pediatric Takayasu arteritis.
• Analysis of clinical data including age, ethnicity, symptoms, imaging, inflammatory markers, and treatment responses.

Main Results:

• The mean age of presentation in the four cases was 11 years (range 8-15).
• Common presentations included arterial hypertension and systemic symptoms, with ischemic pain in limbs, chest, and abdomen.
• Angiography revealed frequent involvement of the left subclavian and common carotid arteries; two patients had renal artery stenosis.
• One patient had an associated Wiskott-Aldrich syndrome, an immune deficiency.

Conclusions:

• Takayasu arteritis in children presents with diverse symptoms, often including hypertension and ischemic manifestations.
• Prompt diagnosis supported by imaging and inflammatory markers is essential for effective management.
• Treatment involves immunosuppressants and antihypertensives, with potential need for surgery, and long-term monitoring is required.