A possible role of sex in determining distribution of lesions in Takayasu Arteritis

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Abstract

Sixty-nine female and 43 male patients of Takayasu Arteritis (TA) were analysed based on their clinical and angiographic features. Clinical manifestations included hypertension in 41 (95%), bruits in 37 (86%) and hypertensive retinopathy in 28 (65%) male patients as compared to 47 (68%), 45 (65%) and 39 (56%) female patients respectively. An increased number of male patients (11.6%) had higher serum creatinine than female patients (1.6%). Angiographic evaluation suggested that female patients had involvement of ascending aorta, arch and abdominal aorta in six (8.6%), 14 (20.5%) and 37 (53.6%) patients respectively as compared to six (13.6%), five (11.6%) and 34 (79.1%) male patients. This data suggests that Indian male patients with TA have a higher frequency of hypertension and abdominal aorta involvement while female patients have a tendency towards involvement of aortic arch and its branches.

Section snippets

Methods and materials

One hundred and twelve patients of TA proved angiographically were included in the present study. All the patients underwent a detailed clinical, biochemical and radiological examination. The clinical examination included recording of blood pressure in all the limbs, auscultation for various bruits, presence or absence of peripheral pulses and a fundus examination. Details of this group have been reported earlier 4, 5.

Results

Of 112 of these patients with TA, there were 89 females and 43 males with a female to male ratio of 1.6:1. Their ages ranged from 5 to 55 years with a mean of 27.8±9.4 years.

The common mode of presentation in our patients included hypertension (52.7%), headache (45.5%), dyspnea (25.9%) and syncope (25.9%). Other features at the time of presentation are shown in Table 1 and Table 2.

The common findings among female patients with TA included hypertension (68%), anaemia (34.8%) and vascular bruit

Discussion

The female to male ratio amongst patients with TA varies from 9.4:1 to 1.6:1 in various countries including Japan, China, Thailand, Korea, Mexico, Israel, Singapore and India 6, 7, 9, 10, 11, 13, 14, 15, 16. Japan, Korea, USA and Mexico have predominant female population amongst patients of TA while India, Thailand and China do not show that female predominance (Table 5).

It is interesting to compare Indian female patients with Japanese patients of TA (Female:male ratio 9.4:1) (Table 6). It

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