Chiew Gek Khor1, Bee Eng Tan, Sow Lai Kan, Esther Ee Ling Tsang, Ai Lee Lim, Eleen Yun Yin Chong, Thundyil Rachel, Cheng Lay Teh, Yet Lin Loh, Shereen Suyin Chʼng, Beryl Agnes dʼSouza, Ainon Mohd Mokhtar, Swee Gaik Ong, Liza Mohd Isa. 1. From the *Rheumatology Unit, Department of Internal Medicine, Pulau Pinang Hospital, Pulau Pinang; †Rheumatology Unit, Department of Internal Medicine, Queen Elizabeth Hospital, Sabah; ‡Rheumatology Unit, Department of Internal Medicine, Sarawak General Hospital, Sarawak; §Rheumatology Unit, Department of Internal Medicine, Sultan Ismail Hospital, Johor; ‖Rheumatology Unit, Department of Internal Medicine, Selayang Hospital, Selangor; ¶Rheumatology Unit, Department of Internal Medicine, Tuanku Jaafar Hospital, Seremban; #Rheumatology Unit, Department of Internal Medicine, Tengku Ampuan Afzan Hospital, Kuantan; **Rheumatology Unit, Department of Internal Medicine, Kuala Lumpur General Hospital, Kuala Lumpur; and ††Rheumatology Unit, Department of Internal Medicine, Putrajaya Hospital, Putrajaya, Malaysia.
Abstract
OBJECTIVE: There is paucity of data for Takayasu arteritis (TAK) among South Asians. We aimed to evaluate the clinical features, angiographic findings, as well as treatment and outcome of TAK among Malaysian multiethnic groups. METHODS: This is a retrospective review of 40 patients with TAK seen in major rheumatology centres in Malaysia between April 2006 and September 2013. RESULTS: Majority were female patients (92.5%), with a female-to-male ratio of 12:1. Median duration of disease from diagnosis was 66 months (interquartile range, 33-177 months). Fifteen (37.5%) were Malays, 9 (22.5%) each were Indians and indigenous from East Malaysia and 7 (17.5%) were Chinese. Indian and indigenous from East Malaysia were overrepresented in this disease. The mean (SD) age of symptom onset and diagnosis were 25.5 (8.1) and 27.4 (8.4), respectively. The 3 most common clinical presentations at diagnosis were diminished or absent pulse, which occurred in 80% of the patients, followed by blood pressure discrepancy (60%) and arterial bruit (52.5%). There was no difference in clinical presentation among ethnic groups. The subclavian artery was the commonest vessel involved (72.5%), followed by the carotid artery (65%) and renal artery (47.5%). Eight patients had coronary artery involvement, and 2 patients had pulmonary artery involvement. Type I arterial involvement was the commonest (80.0%), followed by type IV (35%), present in isolation or mixed type. Glucocorticoid was the main medical treatment (90.0%). Nineteen patients (47.5%) underwent revascularization procedures. Five patients died during the follow-up period. CONCLUSIONS: The Malaysian TAK cohort had similarities with and differences from other published TAK cohort. A nationwide TAK registry is needed to determine the prevalence of the disease among different ethnic groups.
OBJECTIVE: There is paucity of data for Takayasu arteritis (TAK) among South Asians. We aimed to evaluate the clinical features, angiographic findings, as well as treatment and outcome of TAK among Malaysian multiethnic groups. METHODS: This is a retrospective review of 40 patients with TAK seen in major rheumatology centres in Malaysia between April 2006 and September 2013. RESULTS: Majority were female patients (92.5%), with a female-to-male ratio of 12:1. Median duration of disease from diagnosis was 66 months (interquartile range, 33-177 months). Fifteen (37.5%) were Malays, 9 (22.5%) each were Indians and indigenous from East Malaysia and 7 (17.5%) were Chinese. Indian and indigenous from East Malaysia were overrepresented in this disease. The mean (SD) age of symptom onset and diagnosis were 25.5 (8.1) and 27.4 (8.4), respectively. The 3 most common clinical presentations at diagnosis were diminished or absent pulse, which occurred in 80% of the patients, followed by blood pressure discrepancy (60%) and arterial bruit (52.5%). There was no difference in clinical presentation among ethnic groups. The subclavian artery was the commonest vessel involved (72.5%), followed by the carotid artery (65%) and renal artery (47.5%). Eight patients had coronary artery involvement, and 2 patients had pulmonary artery involvement. Type I arterial involvement was the commonest (80.0%), followed by type IV (35%), present in isolation or mixed type. Glucocorticoid was the main medical treatment (90.0%). Nineteen patients (47.5%) underwent revascularization procedures. Five patients died during the follow-up period. CONCLUSIONS: The Malaysian TAK cohort had similarities with and differences from other published TAK cohort. A nationwide TAK registry is needed to determine the prevalence of the disease among different ethnic groups.
Authors: Stella Pui Yan Wong; Chi Chiu Mok; Chak Sing Lau; Man Lung Yip; Lai Shan Tam; King Yee Ying; Woon Leung Ng; Kam Hung Ng; Moon Ho Leung; Tsz Yan Lee; Chi Hung To; Ka Lai Lee; Man Choi Wan; Ka Lung Yu; Priscilla Ching Han Wong; Chi Keung Sung; Kwok Fai Lee; Emily Wai Lin Kun Journal: Rheumatol Int Date: 2018-09-04 Impact factor: 2.631