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The EULAR/PRINTO/PRES criteria for childhood Takayasu arteritis (c-TA) is utilized to determine if a patient satisfies the conditions for this rare, inflammatory disease. It involves evaluating six specific clinical features related to vascular health and inflammatory markers. Each aspect is associated with a distinct score that reflects its diagnostic significance:

- Angiographic abnormalities of the aorta or its main branches and pulmonary arteries stand out as the most significant, carrying a weight of 6 points.
- All other features—pulse deficit or claudication, blood pressure discrepancy in any limb, bruits, hypertension, and elevated acute phase reactant—are each assigned 1 point.

To arrive at the total score, each input is assessed for its presence. If true, it contributes its corresponding numerical value to the overall score. The total possible score ranges from 0 to 11, depending on which criteria are met.

The interpretation of the score offers valuable insights:

- A score of 7 or more indicates that the patient meets the criteria for c-TA, suggesting a strong likelihood of the disease.
- Conversely, a score below 7 implies the criteria are not met, suggesting either the absence of the disease or a requirement for more information or further testing to reach a definitive diagnosis.

This scoring guide forms a structured framework for diagnosing childhood Takayasu arteritis, facilitating a systematic approach to assessment in pediatric patients. Here’s a breakdown of how each criterion contributes to the score:

| Clinical Feature | Score Contribution if Present |
|------------------|-------------------------------|
| Angiographic abnormalities | 6 |
| Pulse deficit or claudication | 1 |
| Blood pressure discrepancy in any limb | 1 |
| Bruits | 1 |
| Hypertension | 1 |
| Elevated acute phase reactant | 1 |

Using this system, clinicians can methodically evaluate whether a child exhibits enough of the characteristic signs to meet the criteria for Takayasu arteritis.

The EULAR/PRINTO/PRES criteria for childhood Takayasu arteritis is a clinical calculator developed by the European League Against Rheumatism (EULAR), the Paediatric Rheumatology International Trials Organisation (PRINTO), and the Paediatric Rheumatology European Society (PRES). This calculator is specifically designed for the diagnosis of Takayasu arteritis in children. 

Takayasu arteritis is a rare type of vasculitis that affects large vessels, particularly the aorta and its main branches. The EULAR/PRINTO/PRES criteria help clinicians to accurately diagnose this condition in pediatric patients, which can be challenging due to the rarity and variable presentation of the disease.

The clinical utility of this calculator is primarily in its ability to guide diagnosis, which can then inform appropriate treatment strategies. Early diagnosis and treatment of Takayasu arteritis can help to prevent serious complications, such as heart failure, stroke, and other organ damage.

There are no specific exclusion criteria for the use of the EULAR/PRINTO/PRES criteria. However, it should be noted that these criteria are intended for use in children, and may not be applicable or accurate for adult patients. Additionally, the criteria should be used in conjunction with other diagnostic tools and clinical

EULAR/PRINTO/PRES criteria for childhood Takayasu arteritis

This tool evaluates disease activity in Takayasu arteritis based on specific criteria. It analyzes new onset or worsening features in patients to determine active disease status. Here's how it works:

- The inputs are taken from a list of four potential clinical features:
  - Systemic symptoms like unexplained fever or musculoskeletal pain.
  - Elevated erythrocyte sedimentation rate (ESR).
  - Signs of vascular ischemia or inflammation, including symptoms like claudication, diminished pulses, bruits, vascular pain (carotodynia), or asymmetric blood pressure in limbs.
  - Characteristic findings on angiographic imaging.

The calculator assesses whether the combinations of these features suggest active disease. 

- If any combination of two or more features exists among the inputs, the system concludes the presence of active disease:
  - Systemic features combined with elevated ESR, vascular ischemia signs, or angiographic findings.
  - Elevated ESR paired with signs of ischemia or notable angiographic changes.
  - Vascular ischemia or inflammation-related symptoms coupled with angiographic changes.

In sum, the presence of active disease is confirmed when at least two of these four features are observed together. The tool outputs "Meets criteria for active disease" for such cases, underscoring the need for careful observation and potential intervention. If less than two features are observed, it implies the disease is not actively progressing according to the NIH criteria, leading to an output of "Criteria not met." This step-by-step assessment helps in the nuanced understanding of disease dynamics, guiding clinical decisions.

The NIH criteria for disease activity in Takayasu arteritis is a clinical tool designed to assess the activity of Takayasu arteritis, a rare form of vasculitis that primarily affects the aorta and its major branches. The criteria are used to identify active disease, which is crucial for guiding treatment decisions and monitoring disease progression.

The primary components of the NIH criteria include new onset or worsening features of systemic symptoms, such as fever and musculoskeletal pain with no other identified cause; elevated erythrocyte sedimentation rate; features of vascular ischemia or inflammation, such as claudication, diminished or absent pulse, bruit, vascular pain, asymmetric blood pressure in either upper or lower limbs, or both; and typical angiographic features. 

The result is determined by the presence of certain combinations of these components. Active disease is identified if the patient exhibits systemic features and an elevated erythrocyte sedimentation rate, or systemic features and features of vascular ischemia or inflammation, or systemic features and typical angiographic features, or an elevated erythrocyte sedimentation rate and features of vascular ischemia or inflammation, or an elevated erythrocyte sedimentation rate and typical angiographic features, or features of vascular ischemia or inflammation and typical angiographic features. If these combinations are not met, the criteria for active disease are not fulfilled. 

This tool is particularly useful in the clinical setting as it provides a structured approach to identifying active disease in patients with Takayasu arteritis, thereby facilitating timely and appropriate management.

NIH criteria for disease activity in Takayasu arteritis

The ACR/EULAR classification criteria for diagnosing Takayasu arteritis involves assessing specific attributes and assigning a score to each. This score helps determine whether the diagnostic criteria for the disease are met. The calculation evaluates four categories: entry criteria, clinical criteria, affected arterial territories, and additional imaging criteria.

- **Entry criteria** includes:
  - Age ≤ 60 years at the time of diagnosis: 30 points
  - Evidence of vasculitis on imaging: 30 points

- **Clinical criteria** provides additional points based on symptoms and signs:
  - Female gender: 1 point
  - Angina or ischemic cardiac pain: 2 points
  - Arm or leg claudication: 2 points
  - Vascular bruit: 2 points
  - Reduced pulse in the upper extremity: 2 points
  - Carotid artery abnormality: 2 points
  - Systolic blood pressure difference in arms ≥ 20 mmHg: 1 point

- **Affected arterial territories** assesses the number of territories involved:
  - 1 territory: 1 point
  - 2 territories: 2 points
  - 3 or more territories: 3 points

- **Additional imaging criteria** can add more to the score:
  - Symmetric involvement of paired arteries: 1 point
  - Abdominal aorta involvement with renal or mesenteric involvement: 3 points

By summing the assigned scores from each input, the calculator provides a total score. The scores range from a minimum of 33 to a potential maximum of 68.

Interpretation of the total score is straightforward:
- A score of 65 or higher means that the diagnostic criteria for Takayasu arteritis are met.
- Scores below 65 indicate that the diagnostic criteria are not satisfied.

This evaluation provides a clear indication of whether the patient's inputs meet the criteria for diagnosing this condition, based on the calculated total score.

The American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) classification criteria for Takayasu arteritis is a clinical tool designed to aid in the diagnosis and classification of Takayasu arteritis. The target patient population includes individuals aged 60 years or younger at the time of diagnosis, with evidence of vasculitis on imaging.

The primary components of the ACR/EULAR classification criteria for Takayasu arteritis include both entry and clinical criteria. Entry criteria encompass age at diagnosis and evidence of vasculitis on imaging. Clinical criteria include factors such as gender, presence of angina or ischemic cardiac pain, arm or leg claudication, vascular bruit, reduced pulse in the upper extremity, carotid artery abnormality, and systolic blood pressure difference in arms. 

The criteria also consider the number of affected arterial territories and additional imaging criteria, such as symmetric involvement of paired arteries and abdominal aorta involvement with renal or mesenteric involvement. These components are integral to the classification of the disease and help clinicians to accurately diagnose and manage patients with Takayasu arteritis.

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