A Case of Takayasu’s Arteritis Presenting With Abdominal Angina and Weight Loss

Author(s):  
Muhammet Emin Erdem
2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110553
Author(s):  
Victoria Birlutiu ◽  
Rares-Mircea Birlutiu ◽  
Mariana Sandu ◽  
Emmanuel Mihali-Oniga

Takayasu’s arteritis is a rare, systemic, inflammatory vasculitis of large blood vessels with an unknown aetiology that more frequently affects women of childbearing age with progression to stenosis, fibrosis or thrombogenesis. Clinical manifestations are associated either with inflammation of the vascular wall (including fever, myalgia, arthralgia, weight loss) or the development of aneurysms and extensive vascular lesions, which creates challenges for a differential diagnosis. This current report presents the case of a female Caucasian patient, aged 23 years, that presented herself repetitively at the hospital reporting symptoms including fever, productive cough, myalgia associated with physical effort, arthralgia, inconstant headache, weight loss and altered general condition. The patient was diagnosed with Takayasu’s arteritis in the context of a prolonged febrile syndrome associated with reactive thrombocytosis. This association results in the need to exclude multiple differential diagnoses. Nonspecific management was initiated, which included antibiotic treatment, antifungal medication, anticoagulants, steroidal anti-inflammatory drugs and correction of anaemia. The patient slowly improved. Takayasu’s arteritis in the inflammatory phase associated with a prolonged febrile syndrome and reactive thrombocytosis is a rare diagnosis of exclusion of a multitude of inflammatory diseases of large blood vessels, infectious diseases and neurofibromatosis, which requires multiple investigations for an accurate diagnosis and management.


2017 ◽  
Vol 6 (1) ◽  
pp. 48-52
Author(s):  
Sujeeb Rajbhandari

Takayasu’s arteritis is a disease of unknown etiology primarily affecting women aged less than 40 years. It is mainly seen in Asians and Africans. This condition is an aorto-arteritis and involves aorta and its major branches causing segmental narrowing or dilatation. Diminished or absent pulses and hypertension are common. Constitutional symptoms, including fever and weight loss, are often accompanied by elevation of acute phase markers. Diagnosis is made usually in quiescent or “cold phase” of the disease. Long-term complications are due mainly to arterial occlusion and related damage, including limb ischemia and renal failure.


2011 ◽  
Vol 2011 (may10 1) ◽  
pp. bcr0220113900-bcr0220113900 ◽  
Author(s):  
S. C. Chaudhary ◽  
A. Gupta ◽  
D. Himanshu ◽  
S. P. Verma ◽  
R. Khanna ◽  
...  

VASA ◽  
2004 ◽  
Vol 33 (4) ◽  
pp. 247-251 ◽  
Author(s):  
Zeller ◽  
Koch ◽  
Frank ◽  
Bürgelin ◽  
Schwarzwälder ◽  
...  

Diagnosis of non-specific aorto-arteritis (NSAA, Takaysu's arteritis) is typically based on clinical and investigational parameters. We report here about two patients with clinically suspected diagnosis of a Takayasu's arteritis already under anti-inflammatory therapy in whom percutaneous transluminal atherectomy of subclavian and axillary artery stenoses was performed to relief the patients from symptoms – intermittent dyspraxia of the arms – and to verify the clinical diagnosis by histology. In the first case aorto-arteritis could be histologically confirmed through the analysis of plaque material including media structures excised from the subclavian and axillary arteries using a new device for atherectomy. The biopsy showed diffuse inflammation and granulomatous lesions with giant cells typically for Takayasu's disease. In the second patient, biopsy showed no acute or chronic inflammatory signs but only atherosclerotic lesions. Percutaneous transluminal atherectomy is therefore not only an interventional but also a diagnostic tool and should be used in every case of interventional therapy of suspected aorto-arteritis to make the clinical diagnosis and as a major consequence the initiation of an aggressive anti-inflammatory medical therapy more reliable.


1988 ◽  
Vol 29 (5) ◽  
pp. 509-513 ◽  
Author(s):  
Z. M. Gu ◽  
G. Lin ◽  
J. R. Yi ◽  
J. M. Li ◽  
J. Zhou ◽  
...  

2020 ◽  
Vol 21 (2) ◽  
pp. 106-111
Author(s):  
N.S. SAMSONOV ◽  
◽  
S.A. USHAKOVA ◽  
O.Y. KHALIDULLINA ◽  
E.A. BASHTAKOVA ◽  
...  

Author(s):  
Simay Erdal ◽  
Banu Nalbantoğlu ◽  
Mert Berke Gür ◽  
Murathan Yıldırım ◽  
Alperen Kılıçarslan ◽  
...  

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110209
Author(s):  
Diana Prieto-Peña ◽  
Pilar Bernabeu ◽  
Paloma Vela ◽  
Javier Narváez ◽  
Jesús C. Fernández-López ◽  
...  

Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu’s arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5–50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0–31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5–50.0) to 5.0 (0.0–5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0–14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX ( n = 28), cyclosporine A ( n = 2), azathioprine ( n = 1). Patients on TCZCOMBO were younger [38.0 (27.0–46.0) versus 45.0 (38.0–57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0–38.0) versus 6.0 (1.0–23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7–5.6) versus 1.3 (0.3–3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.


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