Takayasu's Disease in Middle-Aged Women. A Clinicopathologic Study

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Abstract
Of ten patients with Takayasu's disease (TD), all women, hospitalized in our Service in the last 5 years, seven were more than 38 years old. In these subjects the mean age at diagnosis was 41.2 years. These findings confirm that, in Italy as in other Western countries, including the United States, the diagnosis of TD is usually made later than in Asia and Latin America. This circumstance is proba bly related to actual later onset of the disease. In most of our cases both the anamnestic data and the angiographic findings demonstrated an evolution of the disease with further involvement of other arteries. Several arterial biopsies consistently showed, within a diffuse sclerosis, more or less extensive inflamma tory aggregates characterized by a lymphoplasmacellular infiltration often asso ciated with giant cells. Such a pattern testifies to the persistence of an active arteritis even a long time after the onset of the disease — "persistent active arteritis" instead of "residual arteritis." Pointing out such an evolution of the TD in every stage, our clinicopathologic study emphasizes the importance of a careful followup of the patients; it also advises continuous treatment with corti costeroid drugs, sometimes associated with immunosuppressors, to attain a re duction of the inflammatory process.