Clinical Characteristics And Prognostic Factors Of Takayasu Arteritis In Children

Objective:This study aims to analyze the basic data,clinical manifestations,laboratory examination and imaging data of Takayasu arteritis(TA),summarize its clinical characteristics and prognosis,in order to early diagnosis and treatment,reduce related complications and improve the prognosis of children.Methods:Total 31 TA children were collected and retrospective analyzed from pediatric department of Shengjing hospital,china medical university between 2016 Jan and 2020Dec.Results:1.Basic data:there were 31 children with TA,including 21 girls(67.7%)and 10boys(32.3%).X~2=3.90,P=0.048.Showed significantly difference.The average age of diagnosis was 9 years(3 months-12 years).2.The clinical manifestations of TA Group:15 cases(48.4%)had hypertension symptoms,and this part of the children showed renal artery involvement,10 cases(32.3%)had shortness of breath symptoms,10 cases(32.3%)had fatigue symptoms,9 cases(29.0%)had fever symptoms,4 cases(12.9%)had chest tightness symptoms,and 3 cases(9.7%)had convulsion symptoms.In terms of physical signs,10 cases(32.3%)had audible vascular murmur,10 cases(32.3%)had disproportionate limb blood pressure,and 9 cases(29%)had abnormal peripheral vascular pulsation.3.Laboratory examination:18(58.1%)patients had elevated CRP,19(61.3%)patients had increased ESR,among them,15(48.4%)patients had elevated ESR and CRP at the same time.In terms of etiology,the patients were infected with tuberculosis,Streptococcus,chlamydia,mycoplasma,Epstein Barr virus,herpes simplex virus,adenovirus and cytomegalovirus.4.Vascular involvement:abdominal aorta involvement was the most common(24 cases,77.4%),right renal artery(18 cases,58.1%),carotid artery(14 cases,45.2%),aortic arch or descending aorta(14 cases,45.2%),subclavian artery(11cases,35.5%),superior mesenteric artery(10 cases,32.3%),coronary artery(6 cases,19.4%),limb artery(6 cases,19.4%),pulmonary artery(4 cases,12.9%).5.Survival analysis:the patient if LVEF always<45%orΔLVED always≥8mm,usually have a poor survival.Conclusion:Among children,the incidence of TA is significantly higher in girl than that in boys,the most common clinical manifestation is hypertension,the most commonly affected site is abdominal aorta.In the early stages of TA,there may not be hypertension out of proportion to the blood pressure of the limbs,but TA should be paid attention to if the child continues to have fever,accompanied by elevated inflammatory markers such as CRP,ESR,and anti-inflammatory response is not effective.TA with coronary involvement is common.If the heart continues to be affected,it often indicates poor prognosis.