TAKAYASU ARTERİTİNDE TEK MERKEZ DENEYİMİ

Year 2020, , 596 - 599, 30.12.2020

Muhammet Limon , Dilek Tezcan Semral Gülcemal , Sema Yılmaz

https://doi.org/10.16899/jcm.648730

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

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