Takayasu arteritis in children: preliminary experience with cyclophosphamide induction and corticosteroids followed by methotrexate.
OBJECTIVE
To review the results of our treatment protocol in the last 7 years.


METHODS
Six patients (4 girls, 2 boys) with an age range of 12 to 17 years were diagnosed with Takayasu arteritis (TA) during this period. Patients were allocated to receive (1) oral steroids and methotrexate (MTX) (12.5 mg/m(2)/week) if they had disease limited to one side of the diaphragm only without pulmonary disease involvement (two patients); and (2) oral steroids and oral cyclophosphamide (CYC) (maximum total dose 150 mg/kg) followed by oral MTX for maintenance as above if the disease was more widespread (four patients).


RESULTS
One patient died of pulmonary vasculitis during the first month of therapy. The remaining three patients with involvement of both the thoracic and abdominal aorta and branches received the second protocol for 12 to 18 months. All entered remission. Aortic bypass, aortorenal bypass, balloon dilatation, and unilateral nephrectomy were performed in these patients.


CONCLUSIONS
The presented single-center experience suggests that CYC induction and corticosteroids followed by MTX is an effective and safe treatment for childhood TA.
Ozen
Seza
S
Department of Pediatrics, Pediatric Nephrology and Rheumatology Unit, Hacettepe University Faculty of Medicine, Ankara Turkey. sezaozen@hacettepe.edu.tr <sezaozen@hacettepe.edu.tr>
Duzova
Ali
A
Bakkaloglu
Aysin
A
Bilginer
Yelda
Y
Cil
Barbaros E
BE
Demircin
Metin
M
Davin
Jean Claude
JC
Bakkaloğlu
Mehmet
M
D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018810:Magnetic Resonance Angiography; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D012074:Remission Induction; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008727:Methotrexate