Skip to main content
Log in

Association between Takayasu arteritis and latent or active Mycobacterium tuberculosis infection: a systematic review

  • Review Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Takayasu arteritis (TA) is a granulomatous vasculitis of large vessels with unknown aetiopathogenesis. An association between TA and tuberculosis (TB) has been suggested by several authors. The objective of this study was to perform a systematic review of the literature on the association of Mycobacterium tuberculosis (MT) infection in patients with TA. The research was conducted using the PUBMED/Medline and LILACS databases including studies published until June 2019 and using the descriptors “takayasu arteritis”, “tuberculosis”, “mycobacterium tuberculosis”, “purified protein derivate” (PPD), “mantoux test”, “quantiferon tb gold”, and “interferon gamma release assay” (IGRA). A total of 113 publications were found, but only 38 publications were included after the pre-established criteria were applied. The results were divided into (1) active TB in adolescents with TA: 13 cases; (2) active TB in adults with TA: 116 cases, with a prevalence ranging from 6.3 to 20%, including a South Korean study of 267 cases of TA that found a prevalence of active TB of 17.7%; (3) latent TB in TA patients: the most widely used method was PPD, and only one study compared PPD with IGRA; the prevalence ranged from 20 to 82%; (4) findings that indicate TB in arterial biopsy or autopsies: 5 studies, with different results ranging from an absence of MT DNA in the aortic tissue to 70% positivity; and (5) immunological studies that evaluated the presence of antimycobacterial antibodies and heat shock proteins in TA patients. Although most of the studies show a high prevalence of TB, it is not possible to establish a causal relationship. We suggest that greater care be taken with latent TB screening in patients who are TA candidates for immunosuppressive therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Johnston SLR, Gompels M (2002) Takayasu arteritis: a review. J Clin Pathol 55(7):481–486

    CAS  PubMed  PubMed Central  Google Scholar 

  2. van Timmeren MM, Heeringa P, Kallenberg CG (2014) Infectious triggers for vasculitis. Curr Opin Rheumatol 26(4):416–423

    PubMed  Google Scholar 

  3. Mwipatayi BJP, Beningfield S, Matley P, Naidoo N, Kalla A (2005) Takayasu arteritis: clinical features and management: report of 272 cases. ANZ J Surg 75(3):110–117

    PubMed  Google Scholar 

  4. Kumar Chauhan S, Kumar Tripathy N, Sinha N, Singh M, Nityanand S (2004) Cellular and humoral immune responses to mycobacterial heat shock protein-65 and its human homologue in Takayasu’s arteritis. Clin Exp Immunol 138(3):547–553

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Karadag O, Aksu K, Sahin A, Zihni FY, Sener B, Inanc N et al (2010) Assessment of latent tuberculosis infection in Takayasu arteritis with tuberculin skin test and Quantiferon-TB Gold test. Rheumatol Int 30(11):1483–1487

    PubMed  Google Scholar 

  6. David Moher AL, Tetzlaff J, Douglas G (2009) Altman, The PRISMA group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. PLoS Med 6(7)

  7. Castillo-Martinez D, Amezcua-Guerra LM (2012) Self-reactivity against stress-induced cell molecules: the missing link between Takayasu’s arteritis and tuberculosis? Med Hypotheses 78(4):485–488

    CAS  PubMed  Google Scholar 

  8. Clemente G, Silva CA, Sacchetti SB, Ferriani VPL, Oliveira SK, Sztajnbok F et al (2018) Takayasu arteritis in childhood: misdiagnoses at disease onset and associated diseases. Rheumatol Int 38(6):1089–1094

    CAS  PubMed  Google Scholar 

  9. Cilliers AM, Adams PE, Ntsinjana H, Kala U (2018) Review of children with Takayasu’s arteritis at a Southern African tertiary care centre. Cardiol Young 28(9):1129–1135

    PubMed  Google Scholar 

  10. Khemiri M, Douira W, Barsaoui S (2016) Co-occurrence of Takayasu’s arteritis and tuberculosis: report of a Tunisian pediatric case. Ann Pediatr Cardiol 9(1):75–78

    PubMed  PubMed Central  Google Scholar 

  11. Walters HM, Aguiar CL, Macdermott EJ, Adams A, Barinstein L, Dayton JD et al (2013) Takayasu arteritis presenting in the context of active tuberculosis: a pediatric case. J Clin Rheumatol 19(6):344–347

    PubMed  Google Scholar 

  12. Mukherjee DNP (2013) Active tuberculosis with Takayasu arteritis. Indian Pediatr 50(3):349–350

    PubMed  Google Scholar 

  13. Al-Aghbari K, Al-Motarreb A, Askar F (2010) Takayasu’s arteritis associated with tuberculosis in a young Yemeni woman. Heart Views 11(3):117–120

    PubMed  PubMed Central  Google Scholar 

  14. Almohammadi AA, Consunji-Araneta R (2007) Two cases of Takayasu’s arteritis and tuberculosis. Chest. 132(4):675a-1-a-2

    Google Scholar 

  15. Duzova ATO, Cinar A, Cekirge S, Saatci U, Ozen S (2000) Takayasu’s arteritis and tuberculosis: a case report. ClinRheumatol. 19(6):486

    CAS  Google Scholar 

  16. Jansson MK, Geerdes-Fenge HF, Kangowski A, Kneitz C, Reisinger EC (2019) Tuberculosis and Takayasu arteritis: case-based review. Rheumatol Int 39(2):345–351

    PubMed  Google Scholar 

  17. Lim AY, Lee GY, Jang SY, Gwag HB, Choi SH, Jeon ES et al (2016) Comparison of clinical characteristics in patients with Takayasu arteritis with and without concomitant tuberculosis. Heart Vessel 31(8):1277–1284

    Google Scholar 

  18. Moura C, Aquino MA, Rocha Filho J, Santiago M (2015) Takayasu’s or tuberculous arteritis? BMJ Case Rep 2015

  19. Vista EG, Santos Estrella PV, Lichauco JJ (2010) Flourine-18 flourodeoxyglucose positron emission tomography as a non-invasive test of disease activity in Takayasu’s arteritis--a report of four cases. Autoimmun Rev 9(7):503–506

    PubMed  Google Scholar 

  20. Panico MDBSE, Rodrigues LCD, Oliveira F, Buchatsky D, Porto C et al (2008) Arterite de Takayasu: aspectos clínicos e terapêuticos em 36 pacientes. J Vasc Bras 7:123–130

    Google Scholar 

  21. Modi GMM (2000) Cold agglutinins and cryoglobulins in a patient with acute aortoarteritis (Takayasu’s disease) and tuberculous lymphadenitis. Rheumatology (Oxford) 39(3):337–338

    CAS  Google Scholar 

  22. Jordaan HFVND, Louw M (1994) Papulonecrotic tuberculid. A clinical, histopathological, and immunohistochemical study of 15 patients. Am J Dermatopathol 16(5):474–485

    CAS  PubMed  Google Scholar 

  23. Francès CBS, Blétry O, Dallot A, Thomas D, Kieffer E, Godeau P (1990) Cutaneous manifestations of Takayasu arteritis. A retrospective study of 80 cases. Dermatologica. 181(4):266–272

    PubMed  Google Scholar 

  24. Carvalho ES, de Souza AW, Leao SC, Levy-Neto M, de Oliveira RS, Drake W et al (2017) Absence of mycobacterial DNA in peripheral blood and artery specimens in patients with Takayasu arteritis. Clin Rheumatol 36(1):205–208

    PubMed  Google Scholar 

  25. Benjaminsen E, Reigstad A, Cengija V, Lilleby V, Carlsson M (2016) Stroke as the sole manifestation of Takayasu arteritis in a 15-year-old boy with latent tuberculosis. Case Rep Neurol Med 2016:8736248

    PubMed  PubMed Central  Google Scholar 

  26. Clemente GHM, Lederman H, Silva CA, Sallum AM, Campos LM, Sacchetti S, dos Santos MC, Ferriani VP, Sztajnbok F, Gasparello R, Knupp Oliveira S, Lessa M, Bica B, Cavalcanti A, Robazzi T, Bandeira M, Terreri MT (2014) Takayasu arteritis in a Brazilian multicenter study: children with a longer diagnosis delay than adolescents. Clin Exp Rheumatol 32(3 Suppl 82):128–133

    Google Scholar 

  27. Nooshin DNP, Shahdokht S, Ali J (2013) Ten-year investigation of clinical, laboratory and radiologic manifestations and complications in patients with Takayasu’s arteritis in three university hospitals. Malays J Med Sci 20(3):44–50

    PubMed  PubMed Central  Google Scholar 

  28. Soto ME, Vargas-Alarcon G, Cicero-Sabido R, Ramirez E, Alvarez-Leon E, Reyes PA (2007) Comparison distribution of HLA-B alleles in Mexican patients with Takayasu arteritis and tuberculosis. Hum Immunol 68(5):449–453

    CAS  PubMed  Google Scholar 

  29. Yadav MK (2007) Takayasu arteritis: clinical and CT-angiography profile of 25 patients and a brief review of literature. Indian Heart J 59(6):468–474

    PubMed  Google Scholar 

  30. Robles MRP (1994) Takayasu’s arteritis in Mexico: a clinical review of 44 consecutive cases. Clin Exp Rheumatol 12(4):381–388

    CAS  PubMed  Google Scholar 

  31. Soto ME, Del Carmen A-CM, Huesca-Gomez C, Alarcon GV, Castrejon V, Soto V et al (2012) Detection of IS6110 and HupB gene sequences of Mycobacterium tuberculosis and bovis in the aortic tissue of patients with Takayasu’s arteritis. BMC Infect Dis 12:194

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Arnaud L, Cambau E, Brocheriou I, Koskas F, Kieffer E, Piette JC et al (2009) Absence of Mycobacterium tuberculosis in arterial lesions from patients with Takayasu’s arteritis. J Rheumatol 36(8):1682–1685

    PubMed  Google Scholar 

  33. Chopra P, Datta RK, Dasgupta A, Bhargava S (1983) Non specific aortoarteritis (Takayasu’s disease). An immunologic and autopsy study. Jpn Heart J 24(4):549–556

    CAS  PubMed  Google Scholar 

  34. Aggarwal A, Chag M, Sinha N, Naik (1996) Takayasu’s arteritis: role of Mycobacterium tuberculosis and its 65 kDa heat shock protein. Int J Cardiol 55(1):49–55

    CAS  PubMed  Google Scholar 

  35. Sano K (1961) Obstructive disease of the carotid arteries, with especial reference to angiitis. Med Prog 37:236

    Google Scholar 

  36. Nakao K, Ikeda M, Kimata S, Niitani H, Niyahara M (1967) Takayasu’s arteritis. Clinical report of eighty-four cases and immunological studies of seven cases. Circulation. 35(6):1141–1155

    CAS  PubMed  Google Scholar 

  37. Ueda H (1968) Clinical and pathological studies of aortitis syndrome. Committee report. Jpn Heart J 9(1):76–87

    Google Scholar 

  38. Lee KS, Sohn EY, Hong CY, Kang SR, Berg K (1967) Primary arteritis (Pulseless Disease) in Korean children. Acta Paediatr Scand 56(5):526–536

    CAS  PubMed  Google Scholar 

  39. Kinare SG (1970) Aortitis in early life in India and its association with tuberculosis. J Pathol 100(1):69–76

    CAS  PubMed  Google Scholar 

  40. Lupi-Herrera E, Sanchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE (1977) Takayasu’s arteritis. Clinical study of 107 cases. Am Heart J 93(1):94–103

    CAS  PubMed  Google Scholar 

  41. Wiggelinkhuizen J, Cremin BJ (1978) Takayasu arteritis and renovascular hypertension in childhood. Pediatrics. 62(2):209–217

    CAS  PubMed  Google Scholar 

  42. Pantell RH, Goodman BW Jr (1981) Takayasu’s arteritis: the relationship with tuberculosis. Pediatrics. 67(1):84–88

    CAS  PubMed  Google Scholar 

  43. Moriwaki RNM, Yajima M (1997) Clinical manifestations of Takayasu arteritis in India and Japan—new classification of angiographic findings. Angiology 48:369–379

    CAS  PubMed  Google Scholar 

  44. Sharma BKJS, Radotra BD (1988) An autopsy study of Takayasu arteritis in India. Int J Cardiol 66(Suppl 1):S85–S90

    Google Scholar 

  45. Osman M, Aaron S, Noga M, Yacyshyn E (2011) Takayasu’s arteritis progression on anti-TNF biologics: a case series. Clin Rheumatol 30(5):703–706

    PubMed  Google Scholar 

  46. Ramos A, Garcia R, Sanz J, Daza RM (2011) Radiological deterioration in a patient with cavitary lung lesion. Enferm Infecc Microbiol Clin 29(3):230–231

    PubMed  Google Scholar 

  47. Raffetto JD, Bernardo J,Menzoian JO (2004) Aortobifemoral graft infection with Mycobacterium tuberculosis: treatment with abscess drainage, debridement, and long-term administration of antibiotic agents. J Vasc Surg 40(4):826–829

    PubMed  Google Scholar 

  48. Debashish Danda RG, Danda S, Mohan H, Joseph G, Kabeerdoss J, Nath SK (2017) Interleukin-17F and Interleukin-6 gene polymorphisms in Asian Indian patients with Takayasu arteritis. Hum Immunol

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mittermayer B. Santiago.

Ethics declarations

Disclosures

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pedreira, A.L.S., Santiago, M.B. Association between Takayasu arteritis and latent or active Mycobacterium tuberculosis infection: a systematic review. Clin Rheumatol 39, 1019–1026 (2020). https://doi.org/10.1007/s10067-019-04818-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-019-04818-5

Keywords

Navigation