Takayasu arteritis: epidemiological, clinical, and immunogenetic features in Greece.
OBJECTIVE
Takayasu arteritis (TA) is an uncommon disease with clinical heterogeneity across different ethnic groups. We aimed to evaluate the epidemiological, clinical, and immuno-genetic features of TA in Greece.


METHODS
Demographic, clinical, laboratory, angiographic, and therapeutic data of 42 patients from 4 large referral centers were retrieved. Serology and Human Lymphocyte Antigen (HLA) typing was performed in 22 patients.


RESULTS
We studied 37 women and 5 men with a median age of 31 years at disease onset. Median delay in diagnosis was 24 months and median follow-up was 47 months (range 0-178). Constitutional or musculoskeletal symptoms were present in 86%, especially early in the disease course. Vascular findings were universal with reduced or absent pulse being the most common manifestation (98%). Hypertension was frequent (78%). Extensive disease prevailed and stenotic lesions were more common than aneurysms (95% vs. 40%). Erythrocyte sedimentation rate and C-reactive protein showed modest correlation with disease activity. HLA-B52 was expressed by 37% of the patients vs. 2.4% of the controls (p<0.001). Glucocorticoids and cytotoxic agents were used in most patients with remission rates of 83%. A total of 42 surgical procedures were performed with success rates of 87%.


CONCLUSIONS
TA in Greece clinically and epidemiologically resembles the pattern of disease in Japan and the Western hemisphere. There is considerable delay in diagnosis, which may partially reflect failure to recognize a rare disease. New surrogate markers are needed to assess disease activity. Glucocorticoids are the cornerstone of treatment and cytotoxic drugs are frequently used as steroid sparing agents.
Karageorgaki
Z T
ZT
1st Department of Internal Medicine, Agios Dimitrios General Hospital, Thessaloniki, Greece. zakar@otenet.gr
Bertsias
G K
GK
Mavragani
C P
CP
Kritikos
H D
HD
Spyropoulou-Vlachou
M
M
Drosos
A A
AA
Boumpas
D T
DT
Moutsopoulos
H M
HM
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000792:Angiography; D001808:Blood Vessels / Q000473:pathology; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D005805:Genes, MHC Class I / Q000276:immunology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006115:Greece / Q000453:epidemiology; D015235:HLA-B Antigens / Q000235:genetics / Q000276:immunology; D006801:Humans; D055261:Immunogenetic Phenomena; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D013625:Takayasu Arteritis / Q000453:epidemiology / Q000235:genetics / Q000276:immunology / Q000628:therapy; D055815:Young Adult
D005938:Glucocorticoids; D015235:HLA-B Antigens; D007166:Immunosuppressive Agents