Supplement Article |
OP15. TAKAYASU ARTERITIS: A STUDY OF 104 ITALIAN PATIENTS
Arcispedale S. Maria Nuova, Reggio Emilia, Italy, IRCCS Ospedale Maggiore e Istituto Scientifico Ospedale San Raffaele, Milano, Italy, Istituto Mario Negri, Ranica, Bergamo, Italy
Objective: Since Takayasu arteritis (TA) may present in a different manner in different countries, an Italian collaborative study group was established (ITAKA – Italian Takayasu Arteritis Study Group) with the purpose to identify a significant number of Italian patients with TA and to evaluate its clinical features, angiographic findings, and treatment.
Methods: We identified TA patients using the administrative data of all hospital discharges occurred in Italy between 1995 and 1997 and the Italian TA registry. The diagnosis of TA was made according to the 1990 ACR criteria. Only patients who had been followed during the previous 12 months were included in the study. 104 patients with TA were studied. Data on clinical features, angiographic and laboratory findings, pregnancies, medical and surgical treatment were recorded.
Results: 99% of our patients were Caucasians and females (87.5%) were most frequently affected. The median age at disease onset was 29.2 years. The age <15 years and an erythrocyte sedimentation rate (ESR) <30 mm/h were associated to a higher probability of a delay in diagnosis 
2 years. The most common clinical finding at diagnosis was a bruit (90%). 71% of the patients had at disease onset constitutional/musculoskeletal symptoms.
61 patients had a full aortography: stenosis was the most frequent lesion (93%), followed by occlusion (57%), dilatation (16%) and aneurysm (7%). The number of lesions per patient increased with disease duration. Claudication of the limbs, Raynaud's phenomenon and distal cutaneous hypothermia were more frequent in patients with lesions of subclavian and/or iliac arteries (78.4% vs. 40.0%; p = 0.02). Headache, dizziness, syncopal attacks, convulsions, TIA and stroke were more frequent in patients with lesions of vertebral and/or carotid arteries (62.8% vs. 22.2%; p = 0.005). Hypertension was more frequent in patients with renal artery stenosis (92.0% vs. 30.6%; p<0.0001). The yearly incidence of pregnancies decreased from 8.2 every 100 fertile women before the onset of TA to 2.8 after the onset of the disease. We registered a trend towards an increasing in the percentage of spontaneous abortion after the onset (11% vs. 21%, p = 0.6).
Glucocorticoids were the most frequently used drugs, being prescribed to 86% of patients, while cytotoxic agents were prescribed to 54%. 52 patients underwent to at least one surgical procedure: percutaneous transluminal angioplasty (PTA) was performed in 54% of the patients, by-pass in 42%, PTA with stent in 21%, aneurysm repair and aortic valve replacement in 8% each.
Conclusion: The main socio-demographic and clinical characteristics of our large series of Italian patients with TA are similar to those described in a Japanese nationwide survey. These results suggest that TA could not be so different between Eastern and Western countries, as it has been often claimed.