Clinical spectrum and outcome of Takayasu's arteritis in children

Nolan Hassold; Perrine Dusser; Audrey Laurent; Irene Lemelle; Pascal Pillet; Cloé Comarmond; Arsene Mekinian; Marc Lambert; Tristan Mirault; Ygal Benhamou; Alexandre Belot; Eric Jeziorski; Héloïse Reumaux; Jean Sibilia; Alexandra Desdoits; Olivier Espitia; Albert Faye; Pierre Quartier; David Saadoun; Isabelle Koné-Paut

doi:10.1016/j.jbspin.2024.105735

Clinical spectrum and outcome of Takayasu's arteritis in children

Joint Bone Spine. 2024 Apr 15;91(5):105735. doi: 10.1016/j.jbspin.2024.105735. Online ahead of print.

Authors

Nolan Hassold¹, Perrine Dusser², Audrey Laurent³, Irene Lemelle⁴, Pascal Pillet⁵, Cloé Comarmond⁶, Arsene Mekinian⁷, Marc Lambert⁸, Tristan Mirault⁹, Ygal Benhamou¹⁰, Alexandre Belot³, Eric Jeziorski¹¹, Héloïse Reumaux¹², Jean Sibilia¹³, Alexandra Desdoits¹⁴, Olivier Espitia¹⁵, Albert Faye¹⁶, Pierre Quartier¹⁷, David Saadoun¹⁸, Isabelle Koné-Paut²

Affiliations

¹ Department of paediatric rheumatology and CEREMAIA, Kremlin-Bicêtre Hospital, AP-HP, université de Paris Saclay, Kremlin-Bicêtre, France. Electronic address: nolan.hassold-rugolino@aphp.fr.
² Department of paediatric rheumatology and CEREMAIA, Kremlin-Bicêtre Hospital, AP-HP, université de Paris Saclay, Kremlin-Bicêtre, France.
³ Department of paediatric rheumatology, Femme-Mère-Enfant Hospital, HCL, Lyon, France.
⁴ Department of paediatric oncology, Hôpitaux de Brabois, CHU, Nancy, France.
⁵ Department of paediatrics, Pellegrin Hospital, CHU, Bordeaux, France.
⁶ Department of internal medicine, Lariboisière Hospital, AP-HP, Paris, France.
⁷ Department of internal medicine, Saint-Antoine Hospital, AP-HP, Sorbonne université, Paris, France.
⁸ Department of internal medicine, Claude-Huriez Hospital, CHU, Lille, France.
⁹ Department of vascular medicine, George-Pompidou Hospital, AP-HP, Paris, France.
¹⁰ Department of internal medicine, Charles-Nicolle Hospital, CHU, Rouen, France.
¹¹ Department of paediatrics, Arnaud-de-Villeneuve Hospital, CHU, Montpellier, France.
¹² Department of paediatrics, Jeanne-de-Flandre Hospital, CHRU, Lille, France.
¹³ Department of rheumatology, Arlin d'Alsace Hospital, CHU, Strasbourg, France.
¹⁴ Department of paediatrics, Hôpital de la Côte-de-Nacre, CHU, Caen, France.
¹⁵ Nantes Université, CHU Nantes, Department of internal and vascular medicine, 44000 Nantes, France.
¹⁶ Department of general paediatrics, infectious diseases and internal medecine, Robert-Debré Hospital, AP-HP, Université Paris Cité, Paris, France.
¹⁷ Department of paediatric rheumatology, Necker Hospital, AP-HP, Paris, France.
¹⁸ Department of internal medicine, La Pitié-Salpétrière Hospital, AP-HP, Sorbonne université, Paris, France.

PMID: 38631524
DOI: 10.1016/j.jbspin.2024.105735

Abstract

Objectives: We aimed to compare clinical spectrum and outcome between adults and children with Takayasu's arteritis (TAK) in a European population.

Methods: We made a nationwide retrospective observational study between 1988 and 2019. All adult patients met the ACR diagnostic criteria for TAK and all children met the EULAR/PRINTO/PRES criteria for paediatric TAK.

Results: We identified 46 children and 389 adults with TAK. The male to female ratio was 34/46 (0.74) in the paediatric group compared to 241/274 (0.88) in the adult group (P<0.05). Children presented with significantly more systemic symptoms; i.e., fever (P<0.05), fatigue (P<0.001), weight loss (P<0.001), abdominal pain (P<0.05), and myalgia (P<0.05) while adults had more upper limb claudication (P<0.01). Topography of the lesions differed significantly between the two groups: adults had more damage at the cerebral vasculature (P<0.01), upper and lower limbs (P<0.001) while children had more kidney lesions (P<0.05). Children TAK had more frequent (P<0.01) and higher (P<0.001) biological inflammation than adults. Children received higher dose-weight of corticosteroids (P=0.001) and less biotherapy (P<0.010) at diagnosis. Relapses (P<0.05) and death (8.6% vs 4.9%) were more frequent in children TAK than in adults.

Conclusion: Paediatric TAK seems more severe than adult TAK. Therefore, paediatrics patients may require closer monitoring and systemic use of biological treatment.

Keywords: Biotherapy; Children; Prognosis; Takayasu's arteritis.