Clinical Features and Treatments of Takayasu Arteritis Complicated with Ulcerative Colitis

Toshiki Nakajima¹, Hajime Yoshifuji¹, Chikashi Terao², Takao Fujii¹, Koichiro Ohmura¹, Yoshitaka Imura³, Kosaku Murakami⁴, Ran Nakashima¹, Naoichiro Yukawa¹ and Tsuneyo Mimori¹, ¹Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan, ²Departments of Genetics and Rheumatology, Brigham and Women's Hospital, Boston, MA, ³Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan, ⁴Rheumatology & Clin Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Ulcerative Colitis and takayasu arteritis

Session Information

Date: Tuesday, November 10, 2015

Title: Vasculitis Poster III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Some cases with Takayasu arteritis (TAK) complicated with ulcerative colitis (UC) have been reported. We previously performed a multi-center surveillance of TAK patients complicated with UC (Terao et al., Arthritis Rheumatol 2015) and reported that 30 of 470 TAK patients (6.4%, CI: 4.3-9.0%) were coincident with UC. We also found that the onset of TAK symptoms was approximately 6 year earlier in TAK+UC patients than in TAK-only patients (p=0.007), implying that stronger genetic backgrounds might underlie in TAK+UC patients. In this study, we investigated detailed clinical features of TAK+UC cases in a single center.

Methods: We referred to medical records of 122 Japanese TAK patients in Kyoto University Hospital, and examined their HLA-B genotypes, ages of onsets, symptoms associated with TAK or UC, and treatments.

Results: 7 of 122 TAK patients (5.7%, CI: 2.3-11.5%) had UC. HLA information was available in 6 TAK+UC patients and 77 TAK only patients. All of TAK+UC patients and 38 (49%) TAK only patients had HLA-B52 (p=0.027). In 4 TAK-preceding patients, the onset of TAK was 5.5 ± 4.5 (1-10) years earlier than that of UC, and all of them noticed bloody stool and/or diarrhea as the first symptom of UC. In 3 UC-preceding patients, the onset of UC was 4.0 ± 3.0 years (1-7) years earlier than that of TAK, and 2 of them noticed neck pain as the first symptom of TAK. We did not find particular clinical features of symptoms and signs between TAK-preceding and UC-preceding patients. Biologic agents were used in 43% (3/7) of TAK+UC, whereas in only 7.0% (8/115) of TAK-only patients. Both diseases were well controlled in the 3 TAK+UC patients when treated with biologics (2 with infliximab and 1 with ustekinumab).

Conclusion: While association of HLA-B52 had been reported both in TAK and UC, HLA-B52 was considered as a major genetic background underlying in TAK+UC patients. When stool abnormality is seen in TAK patients with HLA-B52, possible complication of UC could be considered. Biologics may be a therapeutic consideration to control both diseases.

Disclosure: T. Nakajima, None; H. Yoshifuji, None; C. Terao, None; T. Fujii, None; K. Ohmura, None; Y. Imura, None; K. Murakami, None; R. Nakashima, None; N. Yukawa, None; T. Mimori, None.

To cite this abstract in AMA style:

Nakajima T, Yoshifuji H, Terao C, Fujii T, Ohmura K, Imura Y, Murakami K, Nakashima R, Yukawa N, Mimori T. Clinical Features and Treatments of Takayasu Arteritis Complicated with Ulcerative Colitis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/clinical-features-and-treatments-of-takayasu-arteritis-complicated-with-ulcerative-colitis/. Accessed .

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