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World J Clin Pediatr. Dec 9, 2026; 15(4): 120832
Published online Dec 9, 2026. doi: 10.5409/wjcp.120832
Does Takayasu arteritis differ between children and adolescents? Insights from a Russian multicenter cohort
Vera A Podzolkova, Natalia A Geppe, Anastasia A Glazyrina, Sania I Valieva, Ilia S Avrusin, Seda Kh Kurbanova, Svetlana S Vakhlyarskaya, Yulia O Kostina, Valeria T Yudina, Ekaterina A Lagutina, Maria K Osminina, Elena S Zholobova, Nadezhda S Podchernyaeva, Eva P Turginekova, Lyubov S Sorokina, Siuzanna A Davtian, Mikhail M Kostik
Vera A Podzolkova, Natalia A Geppe, Maria K Osminina, Elena S Zholobova, Nadezhda S Podchernyaeva, Siuzanna A Davtian, Department of Children’s Diseases, Sechenov First Moscow State Medical University, Moscow 119991, Moskva, Russia
Vera A Podzolkova, Department of Pediatric and Cardiovascular Surgery, Russian Children’s Clinical Hospital of Pirogov Russian National Research Medical University, Moscow 119571, Moskva, Russia
Anastasia A Glazyrina, Department of Hospital Pediatrics, Pirogov Russian National Research Medical University, Moscow 119571, Moskva, Russia
Sania I Valieva, Seda Kh Kurbanova, Valeria T Yudina, Elena S Zholobova, Department of Rheumatology, Morozov Children’s Moscow City Clinical Hospital, Moscow 119049, Moskva, Russia
Ilia S Avrusin, Eva P Turginekova, Lyubov S Sorokina, Mikhail M Kostik, Department of Pediatry, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Sankt-Peterburg, Russia
Svetlana S Vakhlyarskaya, Ekaterina A Lagutina, Department of Immunology and Rheumatology Department, Russian Children’s Clinical Hospital of Pirogov Russian National Research Medical University, Moscow 119571, Moskva, Russia
Yulia O Kostina, Department of Pediatric Rheumatology No. 1, Clinic of Children’s Diseases, Sechenov’s Center of Maternity and Childhood, Sechenov First Moscow State Medical University, Moscow 119991, Moskva, Russia
Author contributions: Podzolkova VA conceived and designed the study, administered the project, collected and validated the data from all centers, performed the statistical analysis, wrote the original draft; Geppe NA administered the project; Glazyrina AA, Valieva SI, Avrusin IS, Kurbanova SK, Vakhlyarskaya SS, Kostina YO, Yudina VT, Lagutina EA, Turginekova EP, Osminina MK, Zholobova ES, Podchernyaeva NS, and Sorokina LS collected the data; Davtian SA contributed to data collection, performed data entry into the database, wrote the original draft; Kostik MM wrote the original draft and provided overall scientific direction and supervision; and all authors contributed to the article revision, read, and approved the submitted version.
Institutional review board statement: The study was approved by the Local Ethics Committee of Sechenovskiy University (Protocol No. 08-25, April 10, 2025). Written informed consent was obtained from all patients or their legal guardians, in accordance with the Declaration of Helsinki, to protect participants’ rights. All data were collected and processed anonymously.
Informed consent statement: Informed consent was obtained from all subjects involved in the study.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Corresponding author: Mikhail M Kostik, MD, PhD, Professor, Department of Pediatry, Saint Petersburg State Pediatric Medical University, Lytovskaya 2, Saint Petersburg 194100, Sankt-Peterburg, Russia.
kost-mikhail@yandex.ru
Received: March 10, 2026
Revised: March 31, 2026
Accepted: April 16, 2026
Published online: December 9, 2026
Processing time: 195 Days and 6.7 Hours
BACKGROUND
Takayasu arteritis (TA) is a chronic large-vessel vasculitis with significant age-related heterogeneity. Global data highlight differences between adult and pediatric TA, as well as among different pediatric age groups. However, the epidemiology and clinical features of childhood-onset TA in the Russian population are largely unknown.
AIM
To characterize the clinical and laboratory features, age-related differences, and long-term outcomes of TA in a Russian pediatric cohort.
METHODS
A retrospective multicenter cohort study included 79 patients aged under 18 years with TA, diagnosed according to EULAR/PRINTO/PRES criteria, from four centers in the Russian Federation. Demographic, clinical, laboratory, and instrumental data were collected. Patients were stratified into two age groups according to WHO definitions: Children (aged less than 10 years, n = 25) and adolescents (aged 10 years to 17 years inclusive, n = 54). Disease activity was assessed using ITAS2010 and ITAS.A. Statistical analysis was performed using StatTech v.4.12.2.
RESULTS
The median age at onset was 11.0 (8.0-14.0) years, and the time before diagnosis was 8.0 (2.0-17.5) months; females were 78.5%. The most common clinical manifestations were malaise (84.8%), fever (54.4%), and vascular bruits (54.4%). Children under 10 years had a lower proportion of girls (P = 0.016), lower erythrocyte sedimentation rate, C-reactive protein, and platelet levels (P < 0.05), ITAS.A scores (8.9 ± 4.3 vs 12.0 ± 4.4, P = 0.005), required more surgical interventions at diagnosis (32% vs 7.4%, P = 0.008) compared to adolescents. At follow-up, 34.4% of patients had persistent vascular imaging activity despite normalized laboratory parameters. Biological drugs were used in 50.6% of patients. Three patients died, all due to postoperative complications.
CONCLUSION
This pioneer Russian cohort study of childhood-onset TA reveals a unique clinical phenotype. Younger children show lower levels of inflammation than adolescents, yet they still require more surgical intervention.
Core Tip: In this first Russian multicenter cohort study, childhood-onset Takayasu arteritis (TA) presents with distinct age-specific clinical phenotypes. Younger children (< 10 years) exhibit lower inflammatory activity but paradoxically require more frequent surgical interventions, suggesting a “burnt-out” presentation at diagnosis due to diagnostic delays. Vascular damage progresses in one-third of patients despite normalized laboratory parameters, confirming the dissociation between systemic inflammation and vessel wall injury. Tocilizumab was the predominant biologic choice with favorable outcomes. These findings emphasize that conventional inflammatory markers are insufficient for monitoring disease activity and that age-specific management strategies are essential for improving long-term outcomes in pediatric TA.
