SAT0269 TAKAYASU ARTERITIS AND INFLAMMATORY BOWEL DISEASE. COEXISTENCE AMONG NORWEGIAN PATIENTS
Authors: Ø. Palm, B. Gudbrandsson, T. Garen
Journal: Annals of the Rheumatic Diseases (2020)

Background: Takayasu arteritis (TAK) and inflammatory bowel disease (IBD), consisting of ulcerative colitis (UC) and Crohn’s disease (CD), are uncommon diseases. The incidence rates of TAK is 22.0/million and IBD 193/million in Norway (1, 2). UC in patients with TAK has previously been reported with a prevalence between 0,21% and 6.4% and may be explained by shared genetic disposition (3). Epidemiological data are mainly based on one Asian study (3), one Canadian study (4) and case reports. Objectives: We investigated the coexistence of TAK and IBD and compared clinical characteristics between TAK patients with- and without IBD. Methods: We analysed the prevalence of TAK with IBD in a population-based cohort of patients based on the Norwegian Systemic connective tissue disease and Vasculitis Registry (NOSVAR). The diagnoses of TAK were based on either 1990 ACR classification criteria (5) or the modified Ishikawa diagnostic criteria (6). The distribution of vasculitis was recorded in accordance with the angiographic classification of the 1994 International TAK Conference in Tokyo (7). The diagnoses of IBD were based on gastroenterological investigations and conclusions recorded in hospital charts. Results: Among 116 patients with TAK, living in Southern part of Norway (2.5 mill inhabitants) 5 patients (4.3%) had IBD, 3 with UC and 2 with CD. All patients had onset of IBD prior to TAK and intestinal involvement of colon (Table 1). Moreover, patients with TAK and IBD were younger at TAK onset than in those without IBD (Table 2). Table 1. Patients with the combination of Takayasu arteritis (TAK) and Inflammatory bowel disease (IBD); ulcerative colitis (UC) or Crohn’s disease (CD) Age at disease onset (years) Patients IBD Gender F/M IBD extension IBD TAK Vascular complication Distribution of vasculitis (4) 1 UC F Total 12 27 Stenosis and Occlusions I 2 CD F Colon 32 34 Stenosis V 3 UC M Total 11 16 Stenosis and Aneurisms IIB 4 CD K Colon 30 40 Stenosis I 5 CD K Ileocecal+ colon 20 22 Stenosis IIb Table 2. Comparison of Takayasu arteritis (TAK) with- and without IBD TAB/IBD TAK/non-IBD p Number of patients (n%) 5 111 Females (n%) 4 90 (94) Age at TAK onset (years) 27 39 (17) 0.043 Disease duration (years) 1.1 1.4 0.46 Arterial distribution (n%) I 2 17 (15) IIa 0 30 (27) IIb 2 16 (14) III 0 0 IV 0 2 (2) V 1 29 (26) Arterial complications* (n%) Stenosis 5 85 (85) Occlusions 1 30/110 (27) Aneurisms 1/5 (20) 19/132 (14) Carotidynia 2 29 (26) Myocardial infarction 1 5/106 (5) Deceased (n%) 0 23 (16) *Based on CTA, MRA or PET/CT. Conclusion: The presence of IBD in Norwegian patients with TAK is higher than expected by chance. This is comparable to previously reported data from Asian patients (3). Strikingly, onset of IBD preceded TAK in all our cases. The patients with IBD were younger at onset of TAK, but vascular distribution and complication rate did not seem to differ between TAK with and without IBD. References: [1]Gudbrandsson B, Molberg Ø, Garen T, Palm Ø, Arthritis Care Resb (Hoboken), 2017 Sept;69:1384-1390 [2]Moum B, Vatn MH, Ekbom A, Fausa O, Aadland E, Lygren I, Sauar J, Schulz T, Digestion, 1995;56: 377-81 [3]Terao C, Matsumura T, Yoshifuji H, Kirino Y et al, Arthritis Rheumatism, 2015; May 67: 2226-32 [4]Sy A, Khalidi N, Dehghan N, Barra L, Carette S, Semin Arthritis Rheum. 2016 Feb;45:475-82 [5]Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, et al. Arthritis Rheum 1990;33:1129–34 [6]Sharma BK, Jain S, Suri S, Numano F. Diagnostic criteria for Takayasu arteritis. Int J Cardiol 1996;54 Suppl:S141–7. [7]Hata A, Noda M, Moriwaki R, Numano F. Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol 1996;54 Suppl:S155–63. Disclosure of Interests: None declared