Objective: To analyze the trends in Takayasu arteritis (TAK) in Japan during three recent decades based on autopsy reports.
Methods: We extracted TAK cases from the Japanese Pathological Autopsy Reports published during three decades (1991-2000, 2001-2010, 2011-2020) and compared the data for the number of cases, age, gender ratio, malignant tumor complication rate, and cause of death (COD).
Results: 322 TAK cases were reported during the 30 years. They represented 0.04-0.06% of the total autopsies, with little variation among the three decades. The peak age at autopsy increased over time: from the 60s for 1991-2010 to the 70s for 2011-2020. The malignant tumor complication rate increased to 12.2%, 18.5%, and 22.7% during the three decades. However, about half of those cases had no metastases, and malignant tumors were rarely directly involved in a TAK patient's death. TAK-associated cardiovascular lesions (ischemic heart disease, aortic lesions) accounted for most deaths.
Conclusions: Although the age at TAK onset showed little change during the 30 years, the age at autopsy has increased, suggesting that the long-term prognosis has improved. Although the malignant tumor complication rate increased with age, the most common CODs were cardiovascular lesions, which are prognostic factors for TAK.
Keywords: Takayasu arteritis; autopsy; cause of death; malignant tumor; pathology.
© Japan College of Rheumatology 2023. Published by Oxford University Press.