TAKAYASU ARTERİTİNDE TEK MERKEZ DENEYİMİ

Abstract

Giriş-Amaç: Takayasu arteriti(TA), etyolojisi tam olarak bilinmeyen aorta ve ana dalları olmak üzere büyük damarları etkileyen kronik granülomatöz büyük damar vaskülitidir. Bu çalışma ile kliniğimizde takip edilen TA sıklığı ve tedavi cevapları değerlendirilmiştir.

Gereç-Yöntem: Bu çalışma retrospektif olarak Ocak 2016-Ekim 2019 arasında Romatoloji Bilim Dalında yapıldı. Çalışmaya 18 yaş üzeri 1990 Amerika Romatoloji Cemiyeti Kriterlerine göre TA tanısı konulan 20 hasta dahil edildi.

Bulgular: Kliniğimizde retrospektif olarak değerlendirilen 20 tane TA hastasının 17 tanesi kadın, 3 tanesi erkekti.  Hastaların yaş ortalaması 38,2 olarak bulundu. TA’lı hastaların ortalama sedimantasyon: 34 mm/s, CRP: 16 mg/L olarak bulundu. RF ve ANCA bütün hastalarda negatif bulundu. TA’ya bağlı vasküler tutulum değerlendirildiğinde %90 sıklıkta subklavian arter, %50 karotis arter, %40 abdominal aorta, %35 torasik aorta, %15 renal arter tutulumu gözlendi. Medikal tedavide %100 kortikosteroid, %55 siklofosfamid, %45 metotreksat, %25 azatioprin, %5 leflunomid, %5 tosilizumab kullanıldığı gözlendi. Geleneksel tedavi (metotreksat, azatioprin, leflunomid) ile %45 hastanın remisyonda olduğu, %10 hastanın dirençli olması nedeniyle siklofosfamid verildiği görüldü. Hastaların %45’inde yaygın damar tutuluşu nedeniyle siklofosfamid ve kortikosteroid kombinasyonu ilk tedavi olarak tercih edildiği görüldü. Siklofosfamid tedavisi alan hastaların idamesinde sırayla %25  infliksimab,%15 metotreksat,%10 azatioprin, %5  metotreksat ve azatioprin verilmiştir.

Tartışma-Sonuç: Bu çalışmada TA’lı hastaların demografik, klinik, anjiografik bulguları ve medikal tedavi yanıtları değerlendirilmiştir. TA’nın demografik, klinik ve anjiografi bulguları literatür ile uyumlu bulunmuştur. TA’nın medikal tedavisinde kortikosteroidler ve metotreksat, azatioprin, leflunomid gibi geleneksel tedaviler verilir. Geleneksel tedavilere dirençli olgularda anti-TNF, IL-6 blokeri verildiği gözlenmiştir.

Keywords

• Takayasu arteriti,sıklık

References

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