Association between large vessel vasculitis and inflammatory bowel disease: a case-control study.

Area of Science:

• Rheumatology
• Gastroenterology
• Vascular Medicine

Background:

• Large vessel vasculitis (LVV), encompassing Takayasu arteritis (TA) and Giant Cell Arteritis (GCA), can co-occur with inflammatory bowel disease (IBD).
• Understanding the distinct features and outcomes of patients with co-existing LVV and IBD is crucial for effective management.

Purpose of the Study:

• To delineate the specific clinical and imaging characteristics of patients with the association of LVV (TA or GCA) and IBD.
• To compare the outcomes of LVV-IBD patients with those of patients with isolated LVV (iLVV).

Main Methods:

• An observational, multicentre, retrospective case-control study was conducted.
• Cases comprised LVV-IBD patients from European countries, while controls consisted of patients with iLVV (iGCA or iTA).

Main Results:

• The study identified 39 TA-IBD and 12 GCA-IBD cases, compared with 52 iGCA and 93 iTA controls.
• LVV occurred after IBD in a significant proportion of patients (56% in TA-IBD, 75% in GCA-IBD).
• TA-IBD patients were younger at diagnosis and experienced more upper limb claudication than iTA controls. GCA-IBD patients exhibited more arterial thickening/stenosis and a trend towards more gastrointestinal artery involvement compared to iGCA controls.

Conclusions:

• This study highlights specific clinical and imaging features of LVV-IBD patients.
• GCA-IBD patients demonstrated a more severe vascular presentation compared to iGCA patients.
• The presence of IBD did not appear to increase the LVV relapse rate.