Takayasu Arteritis: A Case Series from Tertiary Rheumatology Center from Nepal

Abstract

Background Takayasu arteritis (TA) is an idiopathic, granulomatous, large-vessel arteritis that predominantly involves the aorta, its major branch arteries. Then objective is to evaluate the clinical features, angiographic findings and response of treatment Method 12 patients with TA were studied at the NCRD between 2018 and 2023 and were followed for 3 months to 5 years. Data on clinical features, angiographic and laboratory findings, disease course, and response to therapy were all recorded and stored in a computer-based retrieval system. Result TA was more common in females (54%). The mean age at disease onset was 37.08± 16.91 years. The clinical presentation ranged from asymptomatic to catastrophic with uncontrolled hypertension, gradual loss of vision. The most common clinical finding was a fatigue and dizziness. Hypertension was most often associated with renal artery stenosis (4 out of 12). Almost 50% of the patients had systemic symptoms on presentation. Medical therapy was required for all of the patients. Immunosuppressive treatment with glucocorticoids helped achieve remission (ITAS-0) whereas remaining had decrease in disease activity with one reported mortality. Conclusion In Nepal, Takayasu arteritis is a rare disease. It is heterogeneous in presentation, progression, and response to therapy. Although mortality was low, substantial morbidity occurred in most patients.