Distribution of arterial lesions in Takayasu’s arteritis

Steven R. Ytterberg, M.D., with the Department of Rheumatology at Mayo Clinic in Rochester, Minn., discusses a study that examined similarities and differences between two forms of vasculitis: giant cell arteritis and Takayasu’s arteritis. Findings suggest that TAK and GCA may exist on a spectrum within the same disease. The study was published online on Feb. 10, 2012 in the Annals of the Rheumatic Diseases.

ABSTRACT
Objectives
To compare patterns of arteriographic lesions of the aorta and primary branches in patients with Takayasu’s arteritis (TAK) and giant cell arteritis (GCA).

Methods
Patients were selected from two North American cohorts of TAK and GCA. The frequency of arteriographic lesions was calculated for 15 large arteries. Cluster analysis was used to derive patterns of arterial disease in TAK versus GCA and in patients categorized by age at disease onset.

Using latent class analysis, computer derived classification models based upon patterns of arterial disease were compared with traditional classification.

Results
Arteriographic lesions were identified in 145 patients with TAK and 62 patients with GCA. Cluster analysis demonstrated that arterial involvement was contiguous in the aorta and usually symmetric in paired branch vessels for TAK and GCA. There was significantly more left carotid (p=0.03) and mesenteric (p=0.02) artery disease in TAK and more left and right axillary (p<0.01) artery disease in GCA. Subclavian disease clustered asymmetrically in TAK and in patients ≤55 years at disease onset and clustered symmetrically in GCA and patients >55 years at disease onset.

Computer-derived classification models distinguished TAK from GCA in two subgroups, defining 26 percent and 18 percent of the study sample; however, 56 percent of patients were classified into a subgroup that did not strongly differentiate between TAK and GCA.

Conclusions
Strong similarities and subtle differences in the distribution of arterial disease were observed between TAK and GCA. These findings suggest that TAK and GCA may exist on a spectrum within the same disease.

Authors
Peter C. Grayson, Kathleen Maksimowicz-McKinnon,Tiffany M. Clark, Gunnar Tomasson, David Cuthbertson, Simon Carette, Nader A .Khalidi, Carol A. Langford, Paul A. Monach, Philip Seo, Kenneth J. Warrington, M.D., Steven R. Ytterberg, M.D., Gary S. Hoffman,  and Peter A. Merkel, for the Vasculitis Clinical Research Consortium

Source: http://physicianupdate.mayoclinic.org/2012/04/26/distribution-of-arterial-lesions-in-takayasu%e2%80%99s-arteritis/

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