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FRI0348 Associated inflammatory syndromes in takayasu's arteritis: many faces of a disease
  1. SN Esatoglu1,
  2. AM Celik2,
  3. D Ucar3,
  4. AF Celik4,
  5. S Ugurlu1,
  6. G Hatemi1,
  7. M Melikoglu1,
  8. I Fresko1,
  9. V Hamuryudan1,
  10. H Ozdogan1,
  11. S Yurdakul1,
  12. H Yazici1,
  13. E Seyahi1
  1. 1Istanbul University, Cerrahpasa Medical School, Department of Internal Medicine, Division of Rheumatology
  2. 2Istanbul University, Cerrahpasa Medical School, Department of Internal Medicine
  3. 3Istanbul University, Cerrahpasa Medical School, Department of Ophthalmology
  4. 4Istanbul University, Cerrahpasa Medical School, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey

Abstract

Background Case reports and series suggest that Takayasu's arteritis (TA) can co-exist with various inflammatory disorders.

Objectives We conducted a formal study to look specifically at the frequency of inflammatory disorders and symptoms in a large cohort of TA followed by a single tertiary center.

Methods There were 238 patients registered with a diagnosis of TA. Of these, 19 died, 18 were lost to follow-up and 3 did not wish to response our questionnaire. The remaining 198 patients were called back at the outpatient clinic. A standardized form sought whether the patient was also diagnosed as inflammatory bowel disease (IBD), ankylosing spondylitis (AS), Behçet's syndrome (BS), amyloidosis, uveitis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (pSS), Sjögren syndrome, psoriatic arthritis, inflammatory myositis, small vessel vasculitis, autoimmune/demyelinating or any other inflammatory disorder.

Results Overall, 198 (175 F/ 23 M) patients were studied. The mean age at the time of TA diagnosis was 34±12 years. Subclavian artery was the most common involved artery (84%), followed by common carotids (78%) and aorta (65%). Currently, while 25 (16%) patients were off treatment, 72 (47%) patients were using glucocorticoids, 47 (31%) azathioprine, 32 (21%) methotrexate and 44 (29%) biological agents.

We identified in total 37 (19%) patients with inflammatory diseases (IBD: n=12; AS: n=15; and BS: n=10). Table shows their demographic characteristics. Among the remaining 161 patients, the most frequent feature was inflammatory back pain (36%), followed by recurrent oral ulcers (15%), erythema nodosum (11%), arthritis (10%), papulopustular lesions (7%), uveitis (4%), and genital ulcer (1%). It was noted that inflammatory back was mostly located on the dorsal area. Regarding autoimmune diseases, we also observed RA (n=3), psoriasis (n=2), autoimmune hepatitis (n=2), SS (n=1) and SSc (n=1).

Table 1.

Demographic features of 37 TA patients with inflammatory bowel disease (IBD), ankylosing spondylitis (AS) or Behçet's syndrome (BS)

Conclusions TA does co-occur with IBD, AS or BS in about 1/5 of the patients, at least in a hospital setting and without a clear temporal pattern. This could be due to the close association of TA with MHC class-1 diseases. In addition, the high prevalence of inflammatory back pain in the dorsal spine in TA needs further scrutiny.

Disclosure of Interest None declared

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