Clinical characteristics of 90 children with Takayasu arteritis
10.3760/cma.j.cn141217-20250501-00142
- VernacularTitle:儿童多发性大动脉炎90例临床特点分析
- Author:
Chao LI
1
;
Caifeng LI
1
Author Information
1. 国家儿童医学中心 首都医科大学附属北京儿童医院风湿科，北京 100045
- Publication Type:Journal Article
- Keywords:
Child;
Takayasu arteritis;
Symptoms and signs
- From:
Chinese Journal of Rheumatology
2025;29(7):590-594
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical characteristics of pediatric Takayasu arteritis(TA) to improve its early recognition.Methods:We conducted a retrospective analysis of clinical data from Takayasu arteritis (TA) patients admitted to the Department of Rheumatology at Beijing Children′s Hospital between October 2016 and February 2025, including demographic data, clinical manifestations, inflammatory indicators, etiological examinations, vascular imaging findings, and Numano classification. The clinical characteristics, auxiliary examination results, clinical manifestations of different Numano types, and the comparison between Numano type Ⅳ and type Ⅴ were analyzed. T-test or Mann-Whitney U test and χ2 test was used for comparison between groups. Results:A total of 90 children with TA were included. The male-to-female ratio was 1∶4. The age of onset was (9.6±3.4)years, and the age of diagnosis was (10.0±3.4)years. The median course from onset to diagnosis was 2(1, 6)months. Non-specific systemic symptoms were most common, including fever, fatigue, and poor appetite. Neurological symptoms occurred in 17 patients, with headache being the most frequent. Cardiopulmonary symptoms including chest tightness, palpitations, and lower limb edema were observed in 16 cases, mainly. Hypertension was present in 44 patients (48.9%), vascular bruits in 36 (40.0%), blood pressure asymmetry in 22 (24.4%), and absent/diminished pulses in 20 (22.2%). Elevated CRP and ESR were noted in 63(70.0%) and 69(76.7%) patients, respectively. The left common carotid artery (61 cases, 67.8%) was the most frequently involved vessel, followed by the abdominal aorta (55 cases, 61.1%) and left subclavian artery (50 cases, 55.6%). Vessel wall thickening (59 cases, 65.6%) was the predominant lesion, while luminal stenosis (30 cases, 33.3%) was also common.In the Numano classification, type Ⅴ (42 cases, 46.7%) was the most common, followed by type Ⅳ (18 cases, 20.0%). Both type Ⅳ and type Ⅴ primarily presented with hypertension, and there was no statistically significant difference between the two groups in terms of hypertension, coronary artery involvement, or hypertensive heart disease.Conclusion:The clinical manifestations of Takayasu arteritis in children are highly heterogeneous.For patients with unexplained fever, elevated inflammatory markers, hypertension without obvious cause, vascular bruits, or asymmetric limb blood pressures, vascular imaging should be performed to screen for TA.
