Misra et al reported the Indian Takayasu Clinical Activity Score (ITAS2010) for evaluating a patient with Takayasu's arteritis. The authors are from the Indian Rheumatology Vasculitis (IRAVAS) group.
Patient selection: Takayasu's arteritis
Parameters:
(1) malaise or weight loss (> 2 kg)
(2) myalgias, arthralgias, arthritis
(3) headache
(4) abdominal pain
(5) abortion(s)
(6) diastolic blood pressure
(7) systolic blood pressure
(8) stroke
(9) seizures (non-hypertensive)
(10) syncope
(11) vertigo/dizziness
(12) bruits
(13) pulse and blood pressure inequality between limbs
(14) pulse loss
(15) claudication
(16) carotidynia
(17) aortic incompetence
(18) myocardial infarct or angina
(19) cardiomyopathy or heart failure
(20) ESR in mm in first hour
(21) C-reactive protein
|
Parameters |
Findings |
Points |
|
malaise or weight loss |
no |
0 |
|
|
yes |
1 |
|
myalgia, arthralgia, arthritis |
no |
0 |
|
|
yes |
1 |
|
headache |
no |
0 |
|
|
yes |
1 |
|
abdominal pain |
severe |
1 |
|
|
other |
0 |
|
abortion (if female) |
no |
0 |
|
|
yes |
1 |
|
diastolic blood pressure |
<= 90 mm Hg |
0 |
|
|
> 90 mm Hg |
2 |
|
systolic blood pressure |
<= 140 mm Hg |
0 |
|
|
> 140 mm Hg |
1 |
|
stroke |
no |
0 |
|
|
yes |
2 |
|
seizures |
no |
0 |
|
|
yes |
1 |
|
syncope |
no |
0 |
|
|
yes |
1 |
|
vertigo or dizziness |
no |
0 |
|
|
yes |
1 |
|
bruits |
no |
0 |
|
|
yes |
2 + (number) |
|
pulse or pressure inequality |
no |
0 |
|
|
yes |
2 |
|
pulse loss |
no |
0 |
|
|
yes |
2 + (number) |
|
claudication |
no |
0 |
|
|
arm |
3 |
|
|
leg |
3 |
|
|
both |
4 |
|
carotidynia |
no |
0 |
|
|
yes |
2 |
|
aortic incompetence |
no |
0 |
|
|
yes |
1 |
|
myocardial infarct or angina |
no |
0 |
|
|
yes |
1 |
|
cardiomyopathy or heart failure |
no |
0 |
|
|
yes |
1 |
|
ESR |
< =20 mm in first hour |
0 |
|
|
21 to 39 |
1 |
|
|
40 to 59 |
2 |
|
|
>= 60 |
3 |
|
CRP |
<= 5 mg/dL |
0 |
|
|
6 to 10 |
1 |
|
|
11 to 20 |
2 |
|
|
> 20 |
3 |
where:
• Arteries for bruits (6): right carotid, left carotid, left subclavian, right subclavian, left renal, right renal)
• Arteries for pulse loss (16): carotid, subclavian, brachial, radial, femoral, popliteal, posterior tibial, and dorsalis pedis, taken bilaterally
total score for ITAS =
= SUM(points for clinical findings)
total score for ITAS.A for acute phase reactants =
= (points for ESR) + (points for CRP)
Interpretation:
• minimum ITAS: 0
• maximum ITAS: 51
• minimum ITAS.A: 0
• maximum ITAS.A: 6
• The higher the scores the more severe the Takayasu's arteritis.
Specialty: Immunology/Rheumatology
