BACKGROUND: Takayasu arteritis is a chronic vasculitis often with delayed diagnosis due to the nonspecific presentation of clinical symptoms in its initial phase. Treatment includes imunosuppression drugs. Surgical treatment, when necessary, should be avoided in the acute phase. OBJECTIVE: To describe clinical, laboratory and vascular findings in Takayasu's arteritis from 1977 through 2006. METHODS: The sample was comprised of 36 patients (10 Caucasians, 35 women), mean age of 31.7 (±13.7) years, and significant prevalence in the forth decade (p < 0.005). Disease course was 3 years and time until diagnosis was 7.9 years. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were used to assess disease activity, and duplex scan to measure carotid artery intima-media wall thickness. RESULTS: Hypertension was present in 85.2%, and upper and lower limb claudication in 69.5 and 30.5%, respectively. ESR was > 60 mm in 50% of the sample (p < 0.005). PCR mg/dL was performed in 18 cases, ranging from 0.4-25 on admission to 0.11-1.9 during disease course. Autoimmune diseases, tuberculosis and HIV correlated in 19.4, 8.3 and 2.7%, respectively. Major aortic lesions were detected in 22.2% (four occlusions, two infrarenal aneurysms, one thoracic aneurysm). Other arteries involved renal, subclavian and one carotid occlusion (19%), and some level of lower limb occlusion (25%). Intima-media thickness was stratified in > 3 mm (41.6%), < 3 and > 1.7 (19.4%), < 1.7 and > 1.2 (8.37%), and < 1.2 mm (30.50%) (p < 0.005). Glucocorticoids were used in 61%, azathioprine in 16.6%, and azathioprine combined with cyclophosphamide in 8.3%. Surgical and endovascular procedures were performed in 30.5%. Two patients died due to cardiovascular diseases. CONCLUSIONS: Carotid intima-media thickness, PCR, and ESR are important markers for the follow-up of Takayasu's arteritis. Delay in diagnosis is an important issue for Takayasu's progression, since it may reduce morbidity and mortality rates.
Takayasu's arteritis; imaging diagnosis; duplex scan imaging; carotid; aorta; intimal thickening clinical treatment; surgical treatment
