Epidemio-clinical profile of Takayasu Arteritis at the Center of Tunisia


Najeh Adaily
Anis Mzabi
Jihed Anoun
Donia Ben Hassine
Sara Melki
Neirouz Ghannouchi
Fatma Ben Fredj


Introduction: Takayasu's Arteritis (TA) is a systemic vasculitis affecting the aorta and its main branches.

Aim: To describe the epidemiological, diagnostic, therapeutic and prognostic profile of TA in the referral departments of internal medicine in the Sousse region (Tunisia).

Methods: This is a descriptive, retrospective and exhaustive study, carried out in the two departments of Internal Medicine of Sousse. Patients followed for AT, from 1996 to 2020 were included. The disease was defined according to the classification criteria of the American College of Rheumatology. Disease activity was assessed according to NIH criteria. Age referred to the date of diagnosis.

Results: The study population consisted of 40 patients (Sahloul: n=32, Hached: n=8) with a sex ratio=0.17 and a median age=35 years (IIQ=[30-41]). The median diagnostic delay was 5 months (IIQ=[2-14]). The main clinical sign was pulse abolition and/or decrease (78%). Aortic stenosis was the main arterial lesion found (98%). Treatment was based on corticosteroids (95%) and immunosuppressants (42%). The prognosis of TA was often active (62%), with vascular co-morbidity (60%) and iatrogenic complications (35%).

Conclusion: The epidemiological-clinical profile of AT in the region of Sousse (Tunisia) was characterized by a female predominance, a diagnostic delay, a clinical polymorphism, and evolution towards vascular co-morbidities.


Takayasu arteritis, Vasculitis, Epidemiology, Tunisia, North Africa, Africa



  1. Stamatis P. Giant Cell Arteritis versus Takayasu Arteritis: An Update. Mediterr J Rheumatol. 2020;31(2):174‑82.
  2. Hellmich B, Agueda A, Monti S, Buttgereit F, de Boysson H, Brouwer E, et al. 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2020;79(1):19‑30.
  3. Kermani TA, Warrington KJ, Dua AB. Treatment Guidelines in Vasculitis. Rheum Dis Clin North Am. 2022;48(3):705‑24.
  4. Kechaou M, Frigui M, Ben Hmida M, Bahloul Z. Maladie de Takayasu au sud tunisien: étude de 29 cas. Presse Medicale Paris Fr 1983. 2009;38(10):1410‑4.
  5. Ben Dhaou B, Aydi Z, Boussema F, Ben Dahmen F, Baili L, Ketari S, et al. La maladie de Takayasu en Tunisie: étude mono-centrique de 11 cas. Tunis Med. 2012;90(12):867‑72.
  6. Ghannouchi Jaafoura N, Khalifa M, Rezgui A, Alaoua A, Ben Jazia E, Braham A, et al. La maladie de Takayasu dans la région centre de la Tunisie. A propos de 27 cas. J Mal Vasc. 2010;35(1):4‑11.
  7. Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum. 1990;33(8):1129‑34.
  8. Hata A, Noda M, Moriwaki R, Numano F. Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol. 1996;54 Suppl:S155-163.
  9. Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, et al. Takayasu arteritis. Ann Intern Med. 1994;120(11):919‑29.
  10. Tougorti M, Ben Ghorbel I, Ben Salem T, Houman MH. La maladie de Takayasu dans la population tunisienne : à propos de 53 observations. Rev Médecine Interne. 2019;40:A181.
  11. Sun Y, Yin MM, Ma LL, Dai XM, Lv LJ, Chen XX, et al. Epidemiology of Takayasu arteritis in Shanghai: A hospital-based study and systematic review. Int J Rheum Dis. 2021;24(10):1247‑56.
  12. Zhang Z, Wang W, Zhou M, Lu PYJ, Li Y, Chen Y. An Observational Study of Sex Differences in Takayasu Arteritis in China: Implications for Worldwide Regional Differences. Ann Vasc Surg. 2020;66:309‑17.
  13. Watanabe Y, Miyata T, Tanemoto K. Current Clinical Features of New Patients With Takayasu Arteritis Observed From Cross-Country Research in Japan: Age and Sex Specificity. Circulation. 2015;132(18):1701‑9.
  14. Jiang X, Zhu YJ, Zhou YP, Peng FH, Wang L, Ma W, et al. Clinical features and survival in Takayasu’s arteritis-associated pulmonary hypertension: a nationwide study. Eur Heart J. 2021;42(42):4298‑305.
  15. Bolek EC, Kaya Akca U, Sari A, Sag E, Demir S, Kilic L, et al. Is Takayasu’s arteritis more severe in children? Clin Exp Rheumatol. 2021;39 Suppl 129(2):32‑8.
  16. Tamartash Z, Javinani A, Pehlivan Y, Coskun BN, Yekta RA, Dalkilic E, et al. Comparison of clinicodemographic characteristics and pattern of vascular involvement in 126 patients with Takayasu arteritis: a report from Iran and Turkey. Reumatismo. 2022;74(3).
  17. Li J, Sun F, Chen Z, Yang Y, Zhao J, Li M, et al. The clinical characteristics of Chinese Takayasu’s arteritis patients: a retrospective study of 411 patients over 24 years. Arthritis Res Ther. 2017;19(1):107.
  18. Misra DP, Rathore U, Patro P, Agarwal V, Sharma A. Corticosteroid monotherapy for the management of Takayasu arteritis-a systematic review and meta-analysis. Rheumatol Int. 2021;41(10):1729‑42.
  19. Mammeri A, Guermaz R, Hatri A, Kessal F, Taharboucht S, Hamrour F, et al. Hypertension during Takayasu’s disease: An Algerian single center experience of 279 patients. Ann Cardiol Angeiol (Paris). juin 2017;66(3):154‑8.
  20. Mirouse A, Deltour S, Leclercq D, Squara PA, Pouchelon C, Comarmond C, et al. Cerebrovascular Ischemic Events in Patients With Takayasu Arteritis. Stroke. 2022;53(5):1550‑7.
  21. Goel R, Chandan JS, Thayakaran R, Adderley NJ, Nirantharakumar K, Harper L. Cardiovascular and Renal Morbidity in Takayasu Arteritis: A Population-Based Retrospective Cohort Study From the United Kingdom. Arthritis Rheumatol Hoboken NJ. 2021;73(3):504‑11.
  22. Egebjerg K, Baslund B, Obel N, Faurschou M. Mortality and cardiovascular morbidity among patients diagnosed with Takayasu’s arteritis: a Danish nationwide cohort study. Clin Exp Rheumatol. 2020;38 Suppl 124(2):91‑4.
  23. Jang SY, Park TK, Kim DK. Survival and causes of death for Takayasu’s arteritis in Korea: A retrospective population-based study. Int J Rheum Dis. 2021;24(1):69‑73.
  24. Regola F, Uzzo M, Toniati P, Trezzi B, Sinico RA, Franceschini F. Novel Therapies in Takayasu Arteritis. Front Med. 2021;8:814075.
  25. Saadoun D, Bura-Riviere A, Comarmond C, Lambert M, Redheuil A, Mirault T, et al. French recommendations for the management of Takayasu’s arteritis. Orphanet J Rare Dis. 2021;16(Suppl 3):311.
  26. el Asri A, Tazi-Mezalek Z, Aouni M, Adnaoui M, Mohattane A, Bensaid Y, et al. Takayasu’s disease in Morocco. Report of 47 cases. Rev Med Interne. janv 2002;23(1):9‑20.