Background Large vessel vasculitis include Giant cell arteritis (GCA) and Takayasu's disease. Both these conditions can be associated with aortic inflammatory involvement, detectable by FDG-PET. Aortitis is an indicator of a more severe clinical course of disease.
Objectives We aimed to evaluate the different clinical phenotypes of large vessel vasculitis in a retrospective cohort of patients followed-up at our immunorheumatology outpatient clinic. We further aimed to identify predictors of aortic disease.
Methods We retrospectively reviewed all the clinical records of patients receiving a diagnosis of large vessel vasculitis from 1st January 2010 to 1st January 2016. Clinical, laboratory, hystopathological and imaging data were collected. Non-parametric statistical analysis was performed.
Results We recorded 42 diagnosis of large vessel vasculitis along a 5-year follow-up. Out of them 6 patients were not included in the analysis because of the lack of clinical informations. Median age of general population was 72.5 [64.0–76.0]; at onset, median ESR was 56 mm/h [44–75], while CRP was 6.9 mg/dl [3.4–12.1]. Median follow-up was 12 months [6–28]. 25/36 patients were female (69.4%); headache was the commonest onset symptom (28 cases, 77.8%), while polymyalgia rheumatic was diagnosed in 10 patients (27.8%). Half of the patients underwent a PET to rule out aortitic involvement, which was detected in 14/18 patients. The prevalence of aortic involvement was higher in male (7/11, 63.6%) than in female (7/25, 28%; p=0.04). Headache was always reported in uncomplicated GCA, while it was less frequent in aortitic patients (6/14 patients, 42.8%; p=0.0007). No differences were found with respect to age and laboratory data between patients with and without aortic involvement.
Conclusions Large vessel vasculitis are quite common diseases in elderly people. A subset of patients, characterized by aortic involvement and a more severe prognosis can be detected. The absence of headache and male sex are risk factors for aortitis.
Disclosure of Interest None declared
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