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Takayasu Arteritis in Children NILGUN CAKAR, FATOS YALCINKAYA, ALI DUZOVA, SALIM CALISKAN, AYDAN SIRIN, AYSE ONER, ESRA BASKIN, KENAN BEK, ALPER SOYLU, SUAT FITOZ, AYSUN KARABAY BAYAZIT, ZELAL BIRCAN, SEZA OZEN, NERMIN UNCU, and MESIHA EKIM
ABSTRACT. Methods. Clinical, laboratory, and angiographic findings and outcomes of 19 children with TA were evaluated with a retrospective chart review. The criteria for inclusion were those proposed by the American College of Rheumatology. Results. Mean followup period was 35.89 ± 40.75 months (range 1–168, median 30). There were 14 girls and 5 boys. The mean age at diagnosis was 12.84 ± 2.69 years (range 8–17, median 13). The most common complaints on admission were headache (84%), abdominal pain (37%), claudication of extremities (32%), fever (26%), and weight loss (10%). One patient presented with visual loss. Examination on admission revealed hypertension (89%), absent pulses (58%), and bruits (42%). Angiography revealed type I in 13 patients (aortic arch, descending thoracic, and abdominal aorta), type II in 4 (descending thoracic aorta and abdominal aorta), and type IV in 2 (diffuse aortic and pulmonary artery). The most commonly involved vessels were the renal, subclavian, and carotid arteries. All patients received corticosteroid therapy, and further immunosuppressive therapy was added in 15 patients. Fourteen of the 17 hypertensive patients had renal artery stenosis and 9 underwent surgery or interventional therapy. Thoraco-abdominal bypass graft was performed in 2 patients who had abdominal aortic stenosis. Conclusion. Hypertension is the most common clinical feature at presentation. Corticosteroid and immunosuppressive therapy was effective in the control of disease activity. Angioplasty or bypass grafting was successfully performed when needed. (First Release Mar 15 2008; J Rheumatol 2008;35:913-9) Key Indexing Terms:
TAKAYASU ARTERITIS
From the Department of Nephrology, Ministry of Health Diskapi Children's Hospital, Ankara; Department of Pediatric Nephrology, Ankara University School of Medicine, Ankara; Department of Pediatric Nephrology and Rheumatology, Hacettepe University Faculty of Medicine, Children's Hospital, Ankara; Department of Pediatric Nephrology, Istanbul University Faculty of Medicine, Cerrahpasa, Istanbul; Department of Pediatric Nephrology, Istanbul University Faculty of Medicine, Capa, Istanbul; Department of Nephrology, Ministry of Health Sami Ulus Children's Hospital, Ankara; Department of Pediatric Nephrology, Baskent University Faculty of Medicine, Ankara; Department of Pediatric Nephrology, 19 Mayis University Faculty of Medicine, Samsun; Department of Pediatric Nephrology, 9 Eylul University Faculty of Medicine, Izmir; Department of Radiology, Ankara University School of Medicine, Ankara; Department of Pediatric Nephrology, Cukurova University Faculty of Medicine, Adana; and Department of Pediatric Nephrology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey. Dr. Duzova was supported by The Turkish Academy of Sciences (Programme to Reward Successful Young Scientists, A.D/TUBA – GEBIP/2006-6). N. Cakar, MD, Pediatric Nephrologist, Associate Professor in Pediatrics, Department of Nephrology, Ministry of Health Diskapi Children's Hospital; F. Yalcinkaya, MD, Pediatric Nephrologist, Professor in Pediatrics, Department of Pediatric Nephrology, Ankara University School of Medicine; A. Duzova, MD, Pediatric Nephrologist, Associate Professor in Pediatrics, Department of Pediatric Nephrology and Rheumatology, Hacettepe University Faculty of Medicine, Children's Hospital, Ankara; S. Caliskan, MD, Pediatric Nephrologist, Professor in Pediatrics, Department of Pediatric Nephrology, Istanbul University Faculty of Medicine, Cerrahpasa; A. Sirin, MD, Pediatric Nephrologist, Professor in Pediatrics, Department of Pediatric Nephrology, Istanbul University Faculty of Medicine, Capa; A. Oner, MD, Pediatric Nephrologist, Professor in Pediatrics, Department of Nephrology, Ministry of Health Sami Ulus Children's Hospital; E. Baskin, MD, Pediatric Nephrologist, Professor in Pediatrics, Department of Pediatric Nephrology, Baskent University Faculty of Medicine; K. Bek, MD, Pediatric Nephrologist, Department of Pediatric Nephrology, 19 Mayis University Faculty of Medicine; A. Soylu, MD, Pediatric Nephrologist, Associate Professor in Pediatrics, Department of Pediatric Nephrology, 9 Eylul University Faculty of Medicine; S. Fitoz, MD, Radiologist, Associate Professor in Radiology, Department of Radiology, Ankara University School of Medicine; A. Karabay Bayazit, MD, Pediatric Nephrologist, Associate Professor in Pediatrics, Department of Pediatric Nephrology, Cukurova University Faculty of Medicine; Z. Bircan, MD, Pediatric Nephrologist, Professor in Pediatrics, Department of Pediatric Nephrology, Kocaeli University Faculty of Medicine; S. Ozen, MD, Pediatric Nephrologist, Professor in Pediatrics, Department of Pediatric Nephrology and Rheumatology, Hacettepe University Faculty of Medicine, Children's Hospital, Ankara; N. Uncu, MD, Pediatric Nephrologist, Department of Nephrology, Ministry of Health Diskapi Children's Hospital; M. Ekim, MD, Pediatric Nephrologist, Professor in Pediatrics, Department of Pediatric Nephrology, Ankara University School of Medicine. Address reprint requests to Prof. N. Cakar, Binsesin sitesi 91. sok. No 19, Umitkoy 06530, Ankara, Turkey. E-mail: nilguncakar@hotmail.com Accepted for publication December 15, 2007. |
