Yetişkin Hastalarda Takayasu Arteritinin Klinik Seyri, Tedavisi ve Sonuçları: Retrospektif Bir Analiz

Öz

Amaç: Takayasu arteriti TA ’in klinik fenotipi ve seyri, etnisite ve cinsiyet gibi faktörlerden etkilenebilmektedir. Çalışmada erişkin TA hastalarının damar tutulum paternleri, klinik seyri, tedavi yaklaşımları ve sonuçları değerlendirilmiştir.Gereç ve Yöntemler: Kırk TA hastasının klinik, laboratuvar ve radyolojik görüntüleme sonuçları, ve uygulanan tedaviler retrospektif olarak tarandı. Bulgular: Tanı sırasındaki ortalama yaş 42,5±12,9 yıldı ve 31 hasta %77,5 kadındı. En sık görülen semptom ve bulgular halsizlik %65 , kladikasyo %52,5 , kan basıncı farklılığı %50 ve damarda üfürümdü %60 . Yeni anjiyografik sınıflamaya göre en sık tutulum şekli TipV %47,5 idi. İntimal kalınlaşma en sık karotislerde iken, stenoz-oklüzyon ve anevrizmalar subklavian arterlerde görülmekteydi. Hastaların tümü kortikosteroid tedavisi almıştı. Metotreksat ve azatiopürin en çok tercih edilen immünosupresif ajanlardı. Biyolojik ajanlar 21 hastada %52,5 kullanılmıştı. Hastaların %80’inde remisyon sağlanmıştı. Sonuç: Bizim kohortumuzda, TA erkek cinsiyette literatürde bildirilenden daha yüksektir ve vasküler tutulum paternleri abdominal aort tutulum sıklığı ile kuzey Avrupa popülasyonundan farklı olan Asya ve Afrika popülasyonlarına benzerdir. Hastaların çoğunda kortikosteroid, immünosupresif ve/veya biyolojik ajanlarla yapılan kombinasyon tedavileri ile remisyona ulaşılmıştır

Anahtar Kelimeler

• Takayasu arteriti, Tedavi, Remisyon

Clinical Course, Treatment and Results of Takayasu Arteritis in Adult Patients: A Retrospective Analysis

Abstract

Objective: The clinical phenotype and course of Takayasu's arteritis TA may be affected by factors such as ethnicity and gender. The aim of this study was to evaluate the vascular involvement patterns, clinical course, treatment approaches and outcomes of adult TA patients.Material and Methods: The clinical, laboratory and radiological imaging results, and the treatments of 40 TA patients were reviewed retrospectively.Results: The mean age at the time of the diagnosis was 42.5±12.9 years, and 31 77.5% patients were females. The most common symptoms and signs were fatigue 65% , claudication 52.5% , blood pressure differences 50% and murmur on the vessel 60% . According to the new angiographic classification, type V 47.5% was the most frequent type of involvement. Intimal thickening was most common in the carotid arteries, while stenosis-occlusion and aneurysms were more common in the subclavian arteries. All patients received corticosteroid therapy. Methotrexate and azathioprine were the most preferred immunosuppressive agents. Biological agents were used in 21 patients 52.5% . Remission was achieved in 80% of the patients. Conclusion: In our cohort, TA was higher in the male gender than reported in the literature, and the vascular involvement patterns were similar to the Asian and African populations, who are different from the Northern European population as regards abdominal aortic involvement frequency. Remission was achieved in the majority of patients using combination treatment with corticosteroids and immunosuppressive and/or biological agents

Keywords

• Takayasu arteritis, Treatment, Remission

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