Work

Distinguishing Takayasu Arteritis and Giant Cell Arteritis Based on Large-Vessel Involvement Patterns

Year: 2025

Type: article

Abstract: Purpose: Takayasu arteritis (TAK) and extracranial large-vessel (LV) giant cell arteritis (GCA) share overlapping features, making differential diagnosis between the two diseases challenging.We aimed to identify LV involvement patterns that could accurately differentiate TAK and GCA. Materials and Methods:This retrospective cohort study included 181 patients (TAK, n=175; GCA, n=6).LV involvement patterns were assessed using computed tomography (CT) and/or 18 F-fluorodeoxyglucose positron emission tomography/CT performed at diagnosis.A multivariable logistic regression model was used to identify LV involvement patterns that accurately distinguish TAK and GCA.Area under the curve (AUC) was estimated to determine the accuracy. Results:The right subclavian artery (30.3% vs. 83.3%,p=0.013), aortic arch (13.7% vs. 83.3%,p<0.001), descending aorta (30.3% vs. 100.0%,p=0.001), and abdominal aorta (30.9% vs. 83.3%,p=0.015) were less commonly involved in TAK than in GCA.When categorized according to Hata's classification and clusters, type V (31.4% vs. 83.3%,p=0.016) and cluster 5 (2.3% vs. 83.3%,p<0.001) were less common in TAK than in GCA.Type V demonstrated an AUC of 0.760, whereas cluster 5 showed higher accuracy (AUC=0.905) in distinguishing TAK and GCA.A combination of right subclavian artery and aortic arch involvement (2.358 × right subclavian artery involvement+3.385× aortic arch involvement; cut-off=2.872),derived from the multivariable logistic regression model, yielded the highest accuracy (AUC=0.925).Conclusion: Distinct patterns of LV involvement, particularly aortic arch involvement, either alone or combined with right subclavian artery involvement, could accurately differentiate TAK and GCA.

Source: Yonsei Medical Journal

DOI: 10.3349/ymj.2025.0073

Authors: Oh Chan Kwon, Jang Woo Ha, Min-Chan Park, Yong-Beom Park, Sang-Won Lee

Institutions: Yonsei University, Gangnam Severance Hospital, Yongin Severance Hospital, Severance Hospital

Language: English

Topic: Vasculitis and related conditions

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $700