An autopsy study of Takayasu arteritis in India

Autopsy findings of 10 patients with Takayasu arteritis (TA) are presented. These patients include six females and four males with a mean age of 22.61 +/-10.2 years. Hypertension was the commonest mode of presentation. On auto psy, the vascular lesions in the aorta comprised of stenosis (eight), dilat ation (six), aneurysm (two) and dissection of aorta involving its arch, tho racic and abdominal aorta (one). Abdominal aorta was the commonest site of involvement (nine patients) and renal artery was involved in six patients. Histologically, the three types of lesions were identified - active, fibrot ic and combination of active and fibrotic lesions. Active inflammatory lesi ons in the arterial circuit were present despite a clinically chronic (sile nt) phase of the disease. Cardiac involvement included left ventricular hyp ertrophy (nine), right ventricular hypertrophy (four), biventricular hypert rophy (three), myocarditis (two) (rheumatic and Takayasu's myocarditis - on e patient each) and involvement of coronary artery (one). The pulmonary art ery was involved in two patients. Kidneys showed changes of malignant hyper tension and benign nephrosclerosis in one patient each. Associated tubercul osis was present in four patients. The causes of mortality were congestive heart failure (four), chronic renal failure (two), intracranial bleed, aneu rysmal rupture and pulmonary thromboembolism in one patient each. Thus, the major causes of morbidity and mortality in Indian patients with TA is due to severe uncontrolled hypertension and its effect on heart, kidney and bra in. The disease appears to have a persistent activity for a prolonged perio d even when it appears to be clinically silent. (C) 1998 Elsevier Science I reland Ltd. All rights reserved.