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Pulmonary artery involvement in Takayasu arteritis: a retrospective study in Chinese population

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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.

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Funding

This project was supported by grants from the National Natural Science Foundation of China (91739111, 81500037). The sponsors did not have a role in the study design, data collection and analysis, decision to publish, or manuscript preparation.

Author information

Authors and Affiliations

  1. Sleep Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Xin Xi

  2. Department of Pulmonary and Critical Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Xin Xi & Guangfa Zhu

  3. Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Juan Du & Lili Pan

  4. Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Jiayi Liu

  5. Pulmonary and Critical Care Division, Tufts Medical Center, Boston, MA, USA

    Guanming Qi

Authors
  1. Xin Xi
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  2. Juan Du
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  4. Guangfa Zhu
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  5. Guanming Qi
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  6. Lili Pan
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Contributions

XX conceived the study and drafted the manuscript. JD helped collect clinical data. JL helped collect imaging data. GZ and QG helped revise the manuscript. LP guided the design of this study and modified the paper. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lili Pan.

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Ethics approval and consent to participate

All subjects provided written informed consent. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki and approved by the Clinical Research Ethics Board of Beijing Anzhen Hospital, Capital Medical University (approval number: 2019009X).

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The authors declare that there are no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Xi, X., Du, J., Liu, J. et al. Pulmonary artery involvement in Takayasu arteritis: a retrospective study in Chinese population. Clin Rheumatol 40, 635–644 (2021). https://doi.org/10.1007/s10067-020-05271-5

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  • DOI: https://doi.org/10.1007/s10067-020-05271-5

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