Takayasu arteritis - Treatment and prognosis in a University Center in Brazil

The aim of this study was to evaluate the treatment and evolution of TA pat ients in a University Center in Brazil. This is a retrospective and descrip tive study, that included all patients with TAs who attended the out-patien t clinic at the Univesidade Federal de Sao Pale, between 1993 and 1998. Twe nty-four patients were women and 22 where white. The median age at the time of diagnosis was 27 yo. Full arteriography was performed in 28 patients an d carotid duplex ultrasound plus computed tomography of aorta was done in t wo patients. Type I was found in 4, type II-a and type II in one case each, the type IV in 4 cases and the type V in 20 patients. Regarding the treatm ent only three patients with quiescent disease did not receive any medicati ons. Twenty-seven patients (90%) received prednisone and only ten of these patients achieved disease control. Forth-eight percent of patients who rece ived prednisone showed some side effects. Twelve patients received methotre xate associated to prednisone and 58% of them had a good response. Two pati ents who did not control disease activity with prednisone plus methotrexate received cyclophosphamide without good results. Some surgical procedure wa s performed in ten TA patients. Three patients died during the follow-up. T his study showed that the majority of TA patients attended at a University Center needed association of prednisone and methotrexate to control disease activity, 30% needed some surgical procedures and that may be a cause of d eath in a young patient. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.