Background Takayasu arteritis (TA) is a chronic idiopathic large-vessels vasculitis. Because of its relative rarity, little is known about its inflammatory comorbidities. Concomitant occurrence of TA and inflammatory bowel disease (IBD, >70 cases), sarcoidosis (7 cases), relapsing polychondritis (RP, 2 cases) and erosive arthritis (2 cases) have been reported. It is unknown whether associations occur by chance or because of a common inflammatory background.
Objectives Our purpose was to analyse inflammatory comorbidities in a cohort of TA patients (pts) followed at a single referral Center.
Methods We retrospectively evaluated 70 TA pts referred at our Center between 2000 and 2013. Pts needed to fulfill the ACR classification criteria for TA to be included in the study.
Results 15 TA pts (21%) had inflammatory comorbidities, i.e. RP, psoriasis, IBD, sarcoidosis, seronegative arthritis, episcleritis and coeliac disease (Tab.1). In 9/15 cases (60%) TA onset followed the inflammatory comorbidity, while in 5 cases (33%) TA preexisted. In one case the two conditions appeared simultaneously. TA onset followed the inflammatory comorbidity in 3 out of 4 pts with RP and in the two pts with IBD, while TA preceded sarcoidosis in both cases. Psoriasis, seronegative arthritis and episcleritis appeared either before or after TA.
Conclusions Our data show the coexistence of inflammatory comorbidities in more than one fifth of TA pts. We observed a relatively high frequency (6%) of RP in our cohort. IBD occurred in 3% of our pts, while the expected prevalence of Crohn's disease in TA, if present by chance alone, is approximately 0.05-0.2% (1). The high prevalence of inflammatory diseases in our cohort might suggest a role for a common background facilitating their association with TA. Further studies are needed to confirm our observation and to understand if association of TA and other inflammatory diseases could identify a subset of patients with different prognosis and response to therapies.
Reny JL et al. Association of Takayasu's arteritis and Crohn's disease. Results of a study on 44 Takayasu patients and review of the literature. Annales de medecine interne. 2003;154(2):85-90.
Disclosure of Interest None declared