Age specific clinical manifestations and vascular involvements in childhood-onset Takayasu arteritis.

Background: Limited studies focused on characteristics of childhood-onset Takayasu arteritis (cTAK) throughout growth and development.

Methods: 111 cTAK patients were recruited from six tertiary hospitals across China from January 2009 to December 2021. Patients were classified into infant group (<12 months), toddler and preschool group (≥12 months, <72 months), school-age group (≥72 months, <144 months) and adolescent group (≥144 months).

Results: Infantile cTAK patients tended to had a significantly higher proportion presenting with fever (91.7%, P-trend <0.001), and had significantly higher levels of C-reactive protein (CRP), white blood cells (WBC), platelet (PLT), and lower hemoglobin (HGB) compared to the other three groups (all P < 0.0125). Adolescent patients were more likely to present with headache (33.3%), dizziness (24.2%) and fatigue (51.5%; all P-trend < 0.001). Infantile patients were more likely to have coronary artery involvement (75.0%, P trend < 0.001). Adolescent patients were more likely to have superior mesenteric artery (36.4%, P trend = 0.005), carotid artery (30.3%, P trend = 0.003), and celiac trunk artery stenosis (27.3%, P trend = 0.005).Younger patients, especially infants, had a lower proportion of glucocorticoids use (P trend = 0.001). 73.0% (81/111) of patients were in remission, with a median follow-up time of 2.00 [2.00, 5.00] years.

Conclusion: The age-specific patterns identified in this study offered valuable insights for a comprehensive understanding of cTAK.

Impact: Infantile Takayasu arteritis patients tended to present with fever, elevated inflammatory biomarkers and coronary artery involvement. Adolescent patients were more likely to present with headache, dizziness and fatigue, with superior mesenteric artery, carotid artery involvement and celiac trunk artery stenosis. Clinical manifestations and vascular involvement of childhood-onset Takayasu arteritis differ across age groups. The clinical manifestations of childhood-onset Takayasu arteritis lack specificity. The age-specific patterns identified in this study may provide clues for early diagnosis.