Xin Xi1,2, Juan Du3, Jiayi Liu4, Guangfa Zhu2, Guanming Qi5, Lili Pan6. 1. Sleep Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 2. Department of Pulmonary and Critical Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 3. Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 4. Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 5. Pulmonary and Critical Care Division, Tufts Medical Center, Boston, MA, USA. 6. Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. lilypansxmu@sina.com.
Abstract
BACKGROUND: Takayasu's arteritis (TA) may involve the pulmonary artery, which signifies a poor prognosis. This study investigated the features of TA patients with pulmonary artery involvement. METHODS: One hundred and twenty-six inpatients diagnosed with TA were retrospectively studied. The clinical data of TA patients with and without pulmonary artery involvement were compared. The imaging features of pulmonary artery lesions in TA patients were evaluated. The treatment responses of pulmonary artery lesions were described, and the drug regimens in different treatment response groups were compared. RESULTS: Among the patients with TA, 15.9% showed associated pulmonary artery involvement. The disease durations were significantly longer in patients with pulmonary artery involvement than in those without (108.0 months (53.5, 222.0) vs. 36.0 months (12.0, 120.0); p = 0.038). Hemoptysis was more common in TA patients with pulmonary artery involvement than in those without (15.0%, 3 cases vs. 0.0%; p < 0.001). TA patients with disease duration longer than 5 years showed a 3.42-fold higher odds of pulmonary artery involvement than those with a disease duration of less than 5 years (adjusted odds ratio, 3.42 (95% confidence interval, 1.20-9.76); p = 0.02). The most common imaging manifestations of pulmonary artery involvement were stenosis and occlusion. Among the six patients who had good response to treatment of pulmonary artery lesions, five were treated with the interleukin-6 receptor antagonist tocilizumab. CONCLUSIONS: TA patients with pulmonary artery involvement have a longer course of disease and more symptoms of hemoptysis. TA-related pulmonary artery lesions more commonly manifested as stenosis and occlusion. Tocilizumab may be effective for TA-related pulmonary vascular disease. Key Points • Disease duration longer than 5 years is associated with pulmonary artery involvement in TA. • Hemoptysis is a characteristic clinical symptom of TA with pulmonary artery involvement. • Tocilizumab may be more effective for pulmonary artery lesions of TA.
BACKGROUND:Takayasu's arteritis (TA) may involve the pulmonary artery, which signifies a poor prognosis. This study investigated the features of TA patients with pulmonary artery involvement. METHODS: One hundred and twenty-six inpatients diagnosed with TA were retrospectively studied. The clinical data of TA patients with and without pulmonary artery involvement were compared. The imaging features of pulmonary artery lesions in TA patients were evaluated. The treatment responses of pulmonary artery lesions were described, and the drug regimens in different treatment response groups were compared. RESULTS: Among the patients with TA, 15.9% showed associated pulmonary artery involvement. The disease durations were significantly longer in patients with pulmonary artery involvement than in those without (108.0 months (53.5, 222.0) vs. 36.0 months (12.0, 120.0); p = 0.038). Hemoptysis was more common in TA patients with pulmonary artery involvement than in those without (15.0%, 3 cases vs. 0.0%; p < 0.001). TA patients with disease duration longer than 5 years showed a 3.42-fold higher odds of pulmonary artery involvement than those with a disease duration of less than 5 years (adjusted odds ratio, 3.42 (95% confidence interval, 1.20-9.76); p = 0.02). The most common imaging manifestations of pulmonary artery involvement were stenosis and occlusion. Among the six patients who had good response to treatment of pulmonary artery lesions, five were treated with the interleukin-6 receptor antagonist tocilizumab. CONCLUSIONS: TA patients with pulmonary artery involvement have a longer course of disease and more symptoms of hemoptysis. TA-related pulmonary artery lesions more commonly manifested as stenosis and occlusion. Tocilizumab may be effective for TA-related pulmonary vascular disease. Key Points • Disease duration longer than 5 years is associated with pulmonary artery involvement in TA. • Hemoptysis is a characteristic clinical symptom of TA with pulmonary artery involvement. • Tocilizumab may be more effective for pulmonary artery lesions of TA.
Authors: M Bicakcigil; K Aksu; S Kamali; Z Ozbalkan; A Ates; O Karadag; H T E Ozer; E Seyahi; S Akar; F Onen; A Cefle; S Z Aydin; N Yilmaz; A M Onat; V Cobankara; E Tunc; M A Ozturk; I Fresko; Y Karaaslan; N Akkoc; A E Yücel; S Kiraz; G Keser; M Inanc; H Direskeneli Journal: Clin Exp Rheumatol Date: 2009 Jan-Feb Impact factor: 4.473
Authors: David N Brennan; Kenneth J Warrington; Cynthia S Crowson; Jean Schmidt; Matthew J Koster Journal: Clin Exp Rheumatol Date: 2017-06-12 Impact factor: 4.473