Takayasu arteritis: Follow-up studies for 20 years

Abstract

We reviewed retrospectively 126 (5 male, 121 female) patients suffering from Takayasu arteritis who had been treated in our clinics from 1971 to 1990. The patients' ages ranged from 19 to 80 yrs old (1990) with a mean age of 48.7 +/- 11.8 years. HLA typing analysis in 98 patients revealed that 45 patients (47%) were confirmed as carrying the Bw52 antigen, a high result that is statistically significant as compared with that in healthy Japanese. Arteriograms (performed in 75 patients) revealed that 28 patients (37%) were affected in the aorta and its main branches by this disease (type IV by Nasu's classification) and 23 patients (31%) were affected only in the main branches (type I). The C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) improved significantly from 2.55 +/- 0.28(+) and 57.0 +/- 5.69 mm/hr to 0.53 +/- 0.12(+) and 31.2 +/- 3.45 mm/hr, respectively after treatment including steroid and antiplatelet therapy (P < 0.01). Patients with Bw52 exhibited more severe inflammatory conditions than those without Bw52. Lung scintillations performed in 81 patients showed pulmonary arterial lesions in 50 patients (62%). Echocardiograms revealed aortic regurgitation (AR) in 44 patients (35%), with a significant difference noted between the Bw52 positive group and the Bw52 negative group [29/40 (73%) versus 11/47 (23%), respectively, P < 0.001]. Patients with Bw52 were prescribed higher doses of steroids (P < 0.05) for longer periods (P < 0.01) than those without Bw52.(ABSTRACT TRUNCATED AT 250 WORDS)

Association of susceptibility to Takayasu arteritis in Chinese Han patients with HLA-DPB1

“…The distribution of HLA alleles among different populations is variable, and therefore, the results are also different. For example, HLA-B52 is associated with susceptibility to TA in the Japanese, and B52-positive patients need to be treated with a higher dose of steroids for a longer period as compared with B52-negative patients [25]. Furthermore, HLA A‫,1003ء‬ HLA B‫,1025ء‬ and DRB1‫2051ء‬ alleles increase the susceptibility to TA, whereas A‫2062ء‬ might protect against TA in Koreans [12].…”

Improved Prognosis of Takayasu Arteritis Over the Past Decade

“…We investigated the prevalence of the HLA-B52 allele, and the effect of its presence on the clinical characteristics of TA. 8, 9 This study was approved by the Ethics Review Board at Tokyo Medical and Dental University.…”

The Severity of Takayasu Arteritis Is Associated with the HLA-B52 Allele in Japanese Patients

“…Many cases in the HLA-B52-allele-positive group followed the typical clinical course of TA. In prior studies, associations of HLA-B52 allele with more extensive aortic disease and refractoriness to corticosteroids were also observed (Numano et al 1982;Moriwaki and Numano 1992;Kitamura et al 1998), which might suggest an association of HLA-B52 allele with more active and severe disease.…”

“…Over 20 years ago it was reported that features of a more severe and refractory disease are also associated with the presence of HLA-B52 in Japan: higher blood pressure, acute phase response, and a need for corticosteroids (Numano et al 1982;Moriwaki and Numano 1992). However, Takamura et al (2012) subsequently reported that no significant differences were observed between HLA-B52-positive patients and HLA-B52-negative patients in the following clinical characteristics: age at disease onset, distribution of arteritis, pulmonary involvement, aortic regurgitation (AR), systemic hypertension, steroid resistance, and recurrence rate.…”