Tuberculosis Increases Risk of severe Aortic complications among patients with Takayasu Arteritis: Study

A recent study published in the journal of Advances in Rheumatology revealed a significant link between tuberculosis (TB) and more severe aortic complications in patients with Takayasu arteritis (TA), a rare inflammatory disease affecting large blood vessels. This research analyzed clinical and radiological data of patients treated at a public tertiary referral outpatient clinic in northeast Brazil over 5 years which uncovered notable differences in outcomes between patients with TA who had active or latent TB infections and those without TB.

The retrospective analysis included 50 patients diagnosed with TA between January 2017 and June 2022. Among them, 20 individuals (40%) were identified as having a history of TB, with 6 experiencing active TB and 14 showing evidence of latent TB infection (LTBI). This study compared the clinical presentations and radiological profiles of TA patients based on their TB status.

The key findings indicated that weight loss was significantly more prevalent among TA patients with TB (p=0.005). Furthermore, those with both conditions showed a higher occurrence of abdominal aortic involvement when compared to TA patients without TB (25% vs. 11.4%, p=0.013). The study also reported a markedly increased incidence of vascular dilations (p=0.009) and aneurysms (p=0.027) in the TB-affected group.

Also, other clinical parameters like comorbidities, medication use, inflammatory markers like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, showed no statistically significant differences between the 2 groups. However, the structural damage to the abdominal aorta, including dilations and aneurysms, was identified as a critical distinguishing factor in patients with a TB history. The study highlighted the overlapping histopathological and immunological characteristics of TA and TB, which may contribute to these differences. TB infections, whether active or latent, could exacerbate vascular inflammation and structural damage in TA patients.

These results emphasize the importance of screening for TB in individuals with TA and monitoring for potential vascular complications in those with a TB history. These findings could help guide treatment strategies and improve outcomes for this subset of TA patients. With TB still prevalent in many regions, especially in developing countries, these insights illuminate the need for a multidisciplinary approach to managing conditions like Takayasu arteritis that may interact with infectious diseases in complex ways. 

Source:

Souza Pedreira, A. L., de Oliveira Figueiroa, M. de L. C., Miranda, M. O., de Santana, A. R., Mattos, V. P., da Paz, A. S., Duran, C. C., & Santiago, M. B. (2024). Takayasu’s arteritis associated with tuberculosis: a retrospective study. Advances in Rheumatology (London, England), 64(1), 84. https://doi.org/10.1186/s42358-024-00424-5