Takayasu's arteritis associated with tuberculosis: a distinct disease endotype

Abstract Background: Takayasu arteritis (TA) and tuberculosis (TB) share similar histopathological and immunological characteristics. Studies comparing patients with TA with or without active or latent TB infection (LTBI) have revealed some differences. This study compared the clinical and radiological features of patients with TA with and without active TB or LTBI. Methods: We retrospectively analyzed the secondary data of patients with TA at a public tertiary referral outpatient clinic in northeast Brazil from January 2017 to June 2022. Of these, 50 met the eligibility criteria, and an association with TB was identified in 20 patients (40%; active TB in six and LTBI in 14). Results: Weight loss was more common in patients with TA and TB (p = 0.005). No significant intergroup differences were noted in terms of comorbidities, medications, erythrocyte sedimentation rates, or C-reactive protein levels. Significant differences were found in abdominal aortic involvement (25% of patients with TA and TB; p = 0.013). Dilations (25%) and aneurysms (15.9%) were significantly more common in patients with TA and TB (p = 0.009 and p = 0.027, respectively). Conclusion: Patients with TA and TB have a higher prevalence of dilatation and aneurysms, most commonly in the abdominal aorta. TA with active TB or LTBI represents a distinct endotype in which vasculitis may arise after an infectious trigger.