Takayasu’s arteritis characterizes with severe damage of medium- and large-sized arteries. The pathophysiological progression of full-thickness inflammation of the vessel wall and subsequent fibrosis usually occurs with vascular stenosis and/or occlusion, causing ischemia of the corresponding organs, which is associated with high mortality. the suppression of vascular and systemic inflammation is a major aspect of medical treatment. Glucocorticoids (GC) have been the cornerstone of treatment in TA induction. The remission rate of GC mono-therapy is as high as 60%. However, nearly 80% of patients develop progressive or alternating (recurrence and remission) forms of TA. The current case report focuses on a Asian middle-aged woman who complained pain in arms, headache, cardiodynia, nausea, edema in lower extremities, low appetite, high blood pressure, loss of physical activity, malaise, and fatigue for as many as 6 years. Deferred diagnosis and lack of specific treatment could explain the severity of the arterial injury at time of hospital admission. Angiography showed multiple narrowing and atherosclerosis of the abdominal and thoracic aorta, unilateral occlusion of the subclavian artery, unilateral occlusion of the common carotid artery, stenosis of the celiac trunk, superior mesenteric artery, bilateral renal arteries, enlarged pulmonary trunk, and unilateral hypoplasia of the left kidney. Early diagnosis and treatment is warranted. Outcome appears to be favorable when the disease is quiescent. Renovascular damage and hypertension is usually resistant to medical therapy and frequently requires complex therapy with invasive management methods, such as angioplasty or surgical bypass.
| Published in |
American Journal of Pediatrics (Volume 6, Issue 2)
This article belongs to the Special Issue Chronic Kidney Disease in Children |
| DOI | 10.11648/j.ajp.20200602.26 |
| Page(s) | 152-158 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Takayasu’s Arteritis, Subclavian Artery, Angiography, Multiple Narrowing of the Aorta, Artery Occlusion, Hypoplasia of the Kidney
| [1] | Skeik N, Rodriguez A, Engstrom B. Rare case of Takayasu arteritis with concurrent aneurysmal dilation and stenosis. Int J Angiol 2015; 24: 244–8. https: //doi.org/ 10.1055/s-0035- 1549363. |
| [2] | Skeik N, Ostertag-Hill CA, Garberich RF, Alden PB, Alexander JQ, Cragg AH, et al. Diagnosis, management, and outcome of aortitis at a single center. Vasc Endovasc Surg 2017; 51: 470–9. https: //doi.org/10.1177/1538574417704296. |
| [3] | Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, et al. Takayasu arteritis. Ann Intern Med 1994; 120: 919–29. https: //doi.org/10.7326/0003-4819- 120- 11-199406010-00004. |
| [4] | Alibaz-Oner, F. and Direskeneli, H. Update on Takayasu's arteritis. Presse Med. 2015; 44: e259–e265. |
| [5] | Maritati, F., Iannuzzella, F., Pavia, M. P. et al. Kidney involvement in medium- and large-vessel vasculitis. J Nephrol. 2016; 29: 495–505. doi: 10.1007/s40620-016-0303-8. |
| [6] | Sun Y, Ma L, Chen H, Kong X, Lv P, Dai X, et al. Analysis of predictive factors for treatment resistance and disease relapse in Takayasu’s arteritis. Clin Rheumatol 2018; 37: 2789–95. doi: 10.1007/s10067-018-4094-2. |
| [7] | Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum. 1990; 33: 1129–34. doi: 10.1002/art.1780330811. |
| [8] | Sueyoshi E, Sakamoto I, Hayashi K. Aortic aneurysms in patients with Takayasu's arteritis: CT evaluation. AJR Am J Roentgenol. 2000; 175 (6): 1727–1733. |
| [9] | Song M H, Nakayama T, Hattori K, Tokuda Y, Mabuchi Y, Ueda Y. Aortic root aneurysm in Takayasu arteritis syndrome: exploration in active phase and repair in inactive phase. J Thorac Cardiovasc Surg. 2008; 136 (4): 1084–1085. |
| [10] | Geraldes R, Batista P, Pedro L M, Fernandes A, Melo T P. Takayasu arteritis presenting with internal carotid artery dissection. Cerebrovasc Dis. 2012; 33 (4): 408–409. |
| [11] | Tabata M, Kitagawa T, Saito T. et al. Extracranial carotid aneurysm in Takayasu's arteritis. J Vasc Surg. 2001; 34 (4): 739–742. |
| [12] | Hoyer B F, Mumtaz I M, Loddenkemper K. et al. Takayasu arteritis is characterised by disturbances of B cell homeostasis and responds to B cell depletion therapy with rituximab. Ann Rheum Dis. 2012; 71 (1): 75–79. |
| [13] | Clifford A., Hoffman G. S. Recent advances in the medical management of Takayasu arteritis: an update on use of biologic therapies Curr Opin Rheumatol 2014; 26: 7-15. |
| [14] | Grayson P. C., and al. Association of vascular physical examination findings and arteriographic lesions in large vessel vasculitis J Rheumatol 2012; 39: 303-309. |
| [15] | Ham SW, Kumar SR, Rowe VL, Weaver FA. Disease progression after initial surgical intervention for Takayasu arteritis. J Vasc Surg. 2011; 54: 1345–1351. |
APA Style
Ilkhamdzhan Karimdzhanov, Dilorom Atayeva Rakhimjanovna, Alovkhon Suleymanov, Gulshan Iskanova, Sanjar Egamberdiyev. (2020). Takayasu’s Arteritis with Renovascular Damage: A Case Report. American Journal of Pediatrics, 6(2), 152-158. https://doi.org/10.11648/j.ajp.20200602.26
ACS Style
Ilkhamdzhan Karimdzhanov; Dilorom Atayeva Rakhimjanovna; Alovkhon Suleymanov; Gulshan Iskanova; Sanjar Egamberdiyev. Takayasu’s Arteritis with Renovascular Damage: A Case Report. Am. J. Pediatr. 2020, 6(2), 152-158. doi: 10.11648/j.ajp.20200602.26
AMA Style
Ilkhamdzhan Karimdzhanov, Dilorom Atayeva Rakhimjanovna, Alovkhon Suleymanov, Gulshan Iskanova, Sanjar Egamberdiyev. Takayasu’s Arteritis with Renovascular Damage: A Case Report. Am J Pediatr. 2020;6(2):152-158. doi: 10.11648/j.ajp.20200602.26
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Download@article{10.11648/j.ajp.20200602.26,
author = {Ilkhamdzhan Karimdzhanov and Dilorom Atayeva Rakhimjanovna and Alovkhon Suleymanov and Gulshan Iskanova and Sanjar Egamberdiyev},
title = {Takayasu’s Arteritis with Renovascular Damage: A Case Report},
journal = {American Journal of Pediatrics},
volume = {6},
number = {2},
pages = {152-158},
doi = {10.11648/j.ajp.20200602.26},
url = {https://doi.org/10.11648/j.ajp.20200602.26},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200602.26},
abstract = {Takayasu’s arteritis characterizes with severe damage of medium- and large-sized arteries. The pathophysiological progression of full-thickness inflammation of the vessel wall and subsequent fibrosis usually occurs with vascular stenosis and/or occlusion, causing ischemia of the corresponding organs, which is associated with high mortality. the suppression of vascular and systemic inflammation is a major aspect of medical treatment. Glucocorticoids (GC) have been the cornerstone of treatment in TA induction. The remission rate of GC mono-therapy is as high as 60%. However, nearly 80% of patients develop progressive or alternating (recurrence and remission) forms of TA. The current case report focuses on a Asian middle-aged woman who complained pain in arms, headache, cardiodynia, nausea, edema in lower extremities, low appetite, high blood pressure, loss of physical activity, malaise, and fatigue for as many as 6 years. Deferred diagnosis and lack of specific treatment could explain the severity of the arterial injury at time of hospital admission. Angiography showed multiple narrowing and atherosclerosis of the abdominal and thoracic aorta, unilateral occlusion of the subclavian artery, unilateral occlusion of the common carotid artery, stenosis of the celiac trunk, superior mesenteric artery, bilateral renal arteries, enlarged pulmonary trunk, and unilateral hypoplasia of the left kidney. Early diagnosis and treatment is warranted. Outcome appears to be favorable when the disease is quiescent. Renovascular damage and hypertension is usually resistant to medical therapy and frequently requires complex therapy with invasive management methods, such as angioplasty or surgical bypass.},
year = {2020}
}
TY - JOUR T1 - Takayasu’s Arteritis with Renovascular Damage: A Case Report AU - Ilkhamdzhan Karimdzhanov AU - Dilorom Atayeva Rakhimjanovna AU - Alovkhon Suleymanov AU - Gulshan Iskanova AU - Sanjar Egamberdiyev Y1 - 2020/03/31 PY - 2020 N1 - https://doi.org/10.11648/j.ajp.20200602.26 DO - 10.11648/j.ajp.20200602.26 T2 - American Journal of Pediatrics JF - American Journal of Pediatrics JO - American Journal of Pediatrics SP - 152 EP - 158 PB - Science Publishing Group SN - 2472-0909 UR - https://doi.org/10.11648/j.ajp.20200602.26 AB - Takayasu’s arteritis characterizes with severe damage of medium- and large-sized arteries. The pathophysiological progression of full-thickness inflammation of the vessel wall and subsequent fibrosis usually occurs with vascular stenosis and/or occlusion, causing ischemia of the corresponding organs, which is associated with high mortality. the suppression of vascular and systemic inflammation is a major aspect of medical treatment. Glucocorticoids (GC) have been the cornerstone of treatment in TA induction. The remission rate of GC mono-therapy is as high as 60%. However, nearly 80% of patients develop progressive or alternating (recurrence and remission) forms of TA. The current case report focuses on a Asian middle-aged woman who complained pain in arms, headache, cardiodynia, nausea, edema in lower extremities, low appetite, high blood pressure, loss of physical activity, malaise, and fatigue for as many as 6 years. Deferred diagnosis and lack of specific treatment could explain the severity of the arterial injury at time of hospital admission. Angiography showed multiple narrowing and atherosclerosis of the abdominal and thoracic aorta, unilateral occlusion of the subclavian artery, unilateral occlusion of the common carotid artery, stenosis of the celiac trunk, superior mesenteric artery, bilateral renal arteries, enlarged pulmonary trunk, and unilateral hypoplasia of the left kidney. Early diagnosis and treatment is warranted. Outcome appears to be favorable when the disease is quiescent. Renovascular damage and hypertension is usually resistant to medical therapy and frequently requires complex therapy with invasive management methods, such as angioplasty or surgical bypass. VL - 6 IS - 2 ER -
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