Background Late determination of the disease and high frequency of severe outcomes make Takayasu's arteritis (TA) study an actual problem .
Objectives To identify factors affecting the course of TA and determining its prognosis.
Methods We analyzed 283 case histories of 30 pts, treated in the department of rheumatology of Saratov Regional Hospital since 2ooo to 2013 year. Doppler ultrasound, the levels of C-reactive protein (CRP), circulating immune complexes (CIC), circulating endothelial cells (CEC), and erythrocyte sedimentation rate (ESR) were used for the diagnosis and monitoring of TA. CECs' number was determined by method of J. Hladovec (1978). The pts were divided into 2 groups: I group-with a favorable course of the disease (n=21), II-pts with severe complications (n=9).
Results There were significantly more men in II group than in I (55,5% and 9,5%),significantly greater number of damaged vessels, later onset of basic therapy (10,78±9,2 and 5,36±4,88 years, p<0,05)and shorter its total duration (6,3±4,1 and 1,61±1,10 years, p<0,05). Management was based on the monitoring of the patient every 3-6 months with the assessment of disease activity and the dynamics of vascular lesions. Appointment of therapy and its correction was performed according to the identified changes. After the therapy the levels of CEC and CIC in I group were significantly lower than before treatment. CEC had decreased from 8,9±7,03 to 3,3±2,01. The health of patients in I group due to the treatment remained satisfactory. In II group 11 revascularization operations had been performed and 5 patients died due to severe complications of ischemic character: myocardial infarction, stroke, thrombosis of mesenteric vessels, acute renal failure, massive bleeding in postoperative period.
Conclusions The levels of CEC and CEC are the most informative markers of TA activity. There are several factors, which influence on the course of TA: sex, number and severity of damaged vessels, activity of the disease, the start date of treatment, monitoring and correction of the patient therapy based on activity of the process and the dynamics of vascular lesions, application of optimal treatment, including immunosuppressive, anti-platelet and vasoactive drugs.
A.Balbir-Gurman and Y. Braun-Moscovici. IMAJ 2012; 14: 757-759.
Hladovec. J.Physiol.Bohemoslov.1978; 27: 140-144.
Disclosure of Interest None declared