Gender differences in clinical presentation and vascular pattern in patients with Takayasu arteritis

Area of Science:

• Rheumatology
• Vascular Medicine
• Immunology

Background:

• Takayasu arteritis (TA) is a large-vessel vasculitis with varied clinical manifestations.
• Understanding gender-specific differences in TA is crucial for accurate diagnosis and management.

Purpose of the Study:

• To compare clinical characteristics and vascular involvement patterns at disease onset between male and female patients with Takayasu arteritis.
• To analyze gender-specific differences in demographic features, diagnostic delay, symptoms, and affected arteries.

Main Methods:

• Retrospective collection of data from 117 TA patients (11 male, 106 female) diagnosed by American College of Rheumatology criteria.
• Comparison of demographic features, diagnostic delay, signs, symptoms, and arterial involvement between genders.
• Global analysis combining the study cohort with data from three published studies (total 578 patients; 108 men, 470 women).

Main Results:

• In the overall analysis, men had higher prevalence of arterial hypertension and more frequent involvement of abdominal aorta and renal arteries.
• Women more frequently exhibited upper limb claudication and involvement of the left subclavian artery, carotid arteries, and supradiaphragmatic aorta.
• Inflammatory markers were more frequently elevated in women.

Conclusions:

• Gender significantly impacts the pattern of vascular involvement and clinical presentation in Takayasu arteritis.
• Women with TA predominantly show supradiaphragmatic vessel involvement, whereas men are more frequently affected in the abdominal vasculature.
• These gender-specific patterns necessitate tailored diagnostic and therapeutic approaches in Takayasu arteritis management.