| Popis: |
Takayasu’s arteritis (TA) is a disease of unknown etiology that causes chronic inflammation of the large blood vessels and usually involves the aorta and its branches. The inflammatory process initially leads to thickening of the arterial wall and may result in stenosis, occlusion, dilatation or aneurysm formation. Although TA occurs more commonly in certain regions such as Asia, it is a global disease. Currently, there is a dearth of information on this condition in African countries, including South Africa. Results: We have identified 50 patients meeting the ACR criteria for the diagnosis of TA. Data was drawn from the records of the Division of Rheumatology as well as the angiographic records of TA. This included patient demographics, mode of presentation, classification, co-morbidities, complications, clinical and laboratory features, radiological findings, drug therapy as well as outcomes. The cohort comprised 34 of mixed race, 12 black and 4 white patients. The mean age at diagnosis was 16-56 (28.2) years. The most common presention was hypertension, followed by CVA, heart failure, and syncope. Angiography revealed Type V (most of aorta) and Type I (aortic arch branches) lesions to be the most common and that stenosis was much more common than aneurysm formation. Two patients had concomitant antiphospholipid syndrome. Another two had concomitant internal jugular vein thrombosis. Six patients had significant mediastinal lymphadenopathy, only one of whom had TB. Corticosteroids and additional immunosuppressive therapy were used to control disease activity in most patients. Biological treatment was used in two patients. Surgical intervention consisted mainly of renal auto transplantation. Twelve percent of patients had repeated admissions, which included planned surgical intervention. We had two mortalities, both as a result of massive strokes. The mortality rate was 6%. Only 3 patients had active TB. Conclusion: The study revealed gender and age characteristics similar to previous studies, confirming that TA affects mainly young females. The mortality rate of 6% in this cohort is significantly lower than that of previous series. The unusual findings in this study were: Significant chest lymphadenopathy in 12% of the cases,the significantly lower percentage of active TB of only 6%, two cases of a rare finding of venous thrombosis as well as 2 cases of an uncommon finding in TA of antiphospholipid syndrome. |
