title: Takayasu arteritis in a Brazilian multicenter study: children with a longer diagnosis delay than adolescents.
abstract: OBJECTIVE
  To evaluate and compare demographic, clinical, laboratory and angiographic data of Brazilian children and adolescents with Takayasu's arteritis.
  
  
  METHODS
  In this Brazilian multicentre, retrospective study which included 10 paediatric rheumatology centres, we identified 71 children and adolescents with Takayasu's arteritis which were diagnosed before their 19th birthday. The patients' demographic, clinical, laboratorial and angiographic data were recorded. The participants were divided into two groups: children, defined by the WHO as younger than 10 years old (group 1: 36 patients) and adolescents, defined as individuals aged 10 to 19 years old (group 2: 35 patients). Features of both groups concerning disease manifestations were compared.
  
  
  RESULTS
  A total of 21 (58.3%) patients in group 1 and 30 (85.7%) patients in group 2 were girls (p=0.01). The mean age at disease onset, the mean time to diagnosis, and the mean follow-up time were 5.7 and 12.7, 1.8 and 0.7, 7.2 and 3.6 years, respectively, in groups 1 and 2 (p<0.001, 0.001 and <0.001). At initial evaluation, constitutional symptoms (77.5%) were the most predominant symptoms and decreased peripheral pulses (85.9%) was the most predominant clinical sign without differences between groups. The main laboratory findings were increased erythrocyte sedimentation rate followed by leukocytosis. Anaemia, thrombocytosis and higher platelet levels were significantly more frequent in group 1 (p=0.031, 0.001 and 0.018). Angiographic data were similar in both groups.
  
  
  CONCLUSIONS
  Children presented more laboratory abnormalities but clinical and angiographic characteristics were similar to those presented by the adolescents. Diagnosis delay is longer in younger patients.
authors.affiliation: Division of Pediatric Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, SP, Brazil. gleiceclemente@gmail.com.
authors.forename: Gleice
authors.initials: G
authors.lastname: Clemente
authors.forename: Maria O E
authors.initials: MO
authors.lastname: Hilario
authors.forename: Henrique
authors.initials: H
authors.lastname: Lederman
authors.forename: Clovis A
authors.initials: CA
authors.lastname: Silva
authors.forename: Adriana M
authors.initials: AM
authors.lastname: Sallum
authors.forename: Lucia M
authors.initials: LM
authors.lastname: Campos
authors.forename: Silvana
authors.initials: S
authors.lastname: Sacchetti
authors.forename: Maria C
authors.initials: MC
authors.lastname: dos Santos
authors.forename: Virginia P
authors.initials: VP
authors.lastname: Ferriani
authors.forename: Flávio
authors.initials: F
authors.lastname: Sztajnbok
authors.forename: Rozana
authors.initials: R
authors.lastname: Gasparello
authors.forename: Sheila
authors.initials: S
authors.lastname: Knupp Oliveira
authors.forename: Marise
authors.initials: M
authors.lastname: Lessa
authors.forename: Blanca
authors.initials: B
authors.lastname: Bica
authors.forename: André
authors.initials: A
authors.lastname: Cavalcanti
authors.forename: Teresa
authors.initials: T
authors.lastname: Robazzi
authors.forename: Marcia
authors.initials: M
authors.lastname: Bandeira
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Terreri
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000792:Angiography / Q000379:methods; D001011:Aorta / Q000473:pathology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D062072:Patient Acuity; D012107:Research Design; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013625:Takayasu Arteritis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents