Pathological studies on Takayasu arteritis

Abstract

Takayasu arteritis is a primary inflammatory disease of elastic arteries such as the aorta, its larger branches and the pulmonary artery trunk. According to our recent statistical survey of autopsy cases in Japan, the frequency of the disease in all autopsy cases was approximately 0.033% and the sex ratio was 1:4.5. The most frequent ages of the onset were 20-30 years, those of the death were 40-50 years. The latter was delayed about 20 years in comparison with a previous report. In the recent cases, the vascular lesions widely expanded. Luminal dilatation and aneurysm formation also increased in frequency, their ratio being approximately 57%. In the autopsy cases, the following active lesions were observed: (1) acute exudative inflammation (including suppuration), (2) chronic non-specific productive inflammation and (3) various types of granulomatous inflammation. These findings suggest that many triggers may play a role in the morphogenesis of Takayasu arteritis. The inflammatory lesions are produced in the media and adventitia through the vasa vasorum, and terminate in a diffuse or nodular fibrosis. New active lesions are often observed near the old fibrotic ones. This suggests that Takayasu arteritis may be a progressive disease. Intimal thickening of the peripheral branches from the affected arteries is very often observed. In consequence, secondary ischemic lesions are formed in various organs, especially the heart, brain and kidneys.

IgG4‐related systemic disease and lymphoplasmacytic aortitis

“…Noninfectious aortitis occurs in the setting of a number of large-vessel vasculitides, including giant cell arteritis, Takayasu arteritis, Behçet's syndrome, and Cogan's syndrome (2,(21)(22)(23)(24)(25)(26). Certain connective tissue diseases, e.g., rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, and relapsing polychondritis, also occasionally lead to aortitis (3)(4)(5)(6)27).…”

Percutaneous Transluminal Angioplasty and Stenting for Pulmonary Stenosis Due to Takayasu's Arteritis: Clinical Outcome and Four‐year Follow‐up

“…3 Pulmonary artery involvement in Takayasu's arteritis is well-known, the incidence has been reported from 14% to 86%. 4 -6 However, it usually accompanies aortic involvement.…”

“…12 We diagnosed these patients with isolated Takayasu's pulmonary arteritis according to the following points: (1) onset age was young. According to the American College of Rheumatology Criteria for the Classification of Takayasu's Arteritis, a main criterion was onset age 40 years; 13 (2) pulmonary angiographic findings were consistent with Takayasu's arteritis, which presented with vessel wall thickness and narrowing and occlusion of the vessel lumen; 12 (3) there was no evidence of other systemic vasculitises. Urinary sediment was normal and serological markers of connective diseases were negative.…”

Long-Term Patency of an Aorta-Aortic Graft Bypass in a Patient with Takayasu Arteritis.

“…Althoughits etiology is unknown (1)(2)(3)(4)6), ithas been accepted that an autoimmune process is primarily responsible for the genesis of the disease (4, 19) causing an extensive inflammatory process with destruction of the elastic media of the aorta and its main branches (6,20). Extensive evidence indicates a significant linkage between this autoimmune process and hereditary factors (21)(22)(23).…”