Takayasu’s Arteritis: A Case Report and Review of Literature

Authors

  • กฤติกา ศิริธานันท์ ภาควิชาอายุรศาสตร์ คณะแพทยศาสตร์วชิรพยาบาล มหาวิทยาลัยนวมินทราธิราช

Keywords:

Takayasu, arteritis, vasculitis, stroke

Abstract

Takayasu’s arteritis is a rare type of idiopathic, medium and large vessel vasculitis involving aorta and its main branches. There were several clinical presentations, depending on the vessel involved. The author reports a case of 35-year-old woman presenting with subacute headache, vomiting and coexisting focal neurological symptoms including speech difficulty and weakness of right side arm and leg one day before arrival. The initial physical examination revealed the present of systolic bruit over the left supraclavicular area. The decrease of pulsation of left radial artery and blood pressure of left brachial artery were detected (128/81 mmHg in the right arm and 92/72 mmHg in the left arm). The neurological examination revealed motor aphasia and right hemiparesis. National Institute of Health Stroke Score was 9/42. Computed tomographic of the brain showed hypodensity lesion in the left frontoparietal white matter. Initially, she was treated with the standard acute stroke medication with antiplatelet and HMG CoA reductase inhibitor. During the admission, she developed an episode of transient loss of vision of her left eye, and then fully recover within thirty minutes. The laboratory examinations showed an elevated C-reactive protein and normal erythrocyte sedimentation rate. The subsequent magnetic resonance angiography of brain demonstrated severe narrowing of the left proximal internal carotid artery, and left brachiocephalic artery and evidence of left subclavian steal phenomenon. Multi-foci of luminal narrowing involving medium-sizes intracranial vessels were also observed. Then, she was diagnosed as Takayasu’s arteritis.

References

Gulati A, Bagga A. Large vessel vasculitis. Pediatr Nephrol 2010 June; 25 (6): 1037-48.

Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol 2002;55:481–6.

Hall S, Barr W, Lie JT, Stanson AW, Kazmier FJ, Hunder GG.Takayasu arteritis: a study of 32 North American patients. Medicine (Baltimore)1985; 64(2):
89–99.

Hashimoto Y, Tanaka M, Hata A, Kakuta T, Maruyama Y, Numano F. Four years follow-up study in patients with Takayasu arteritis and severe aortic
regurgitation; assessment by echocardiography. Int J Cardiol 1996;54 Suppl:S173-6.

Seko Y, Sato O, Takagi A, Tada Y, Matsuo H, Yagita H, et al. Restricted usage of T-cell receptor Valpha-Vbeta genes in infiltrating cells in aortic
tissue of patients with Takayasu’s arteritis. Circulation 1996;93(10):1788-90.

Maksimowicz-McKinnon K, Clark TM, Hoffman GS. Limitations of therapy and a guarded prognosis in an American cohort of Takayasu arteritis patients.
Arthritis Rheum 2007; 56(3):1000-9.

Worrall M, Atebara N, Meredith T, Mann E. Bilateral ocular ischemic syndrome in Takayasu disease. Retina. 2001;21:75-76

Nakao K, Ikeda M, Kimata S, Niitani H, Niyahara M. Takayasu’s arteritis. Clinical report of eighty-four cases and immunological studies of seven cases.
Circulation 1967;35(6): 1141-55.

Lupi-Herrera E, Sanchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE. Takayasu’s arteritis. Clinical study of 107 cases. Am Heart J 1977;93(1):
94-103.

Sagar S, Kar S, Gupta A, Sharma BK. Ocular changes in Takayasu’s arteritis in India. Jpn J Ophthalmol. 1994;38:97-102.

Cakar N, Yalcinkaya F, Duzova A, Caliskan S, Sirin A, Oner A et al. Takayasu arteritis in children. J Rheumatol 2008;35: 913-9.

Juergen B, Brian F, Pascal T, Jasmin K, Lothar Z, Ingmar G, Susanne B. Takayasu arteritis in children and adolescents. Rheumatology 2010;49:1806-14.

Kerr CS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, Hoffman GS. Takayasu’s arteritis. Ann Intern Med 1994;120:919-29.

Downloads

Published

2019-02-13

How to Cite

1.
ศิริธานันท์ ก. Takayasu’s Arteritis: A Case Report and Review of Literature. J Thai Stroke Soc [Internet]. 2019 Feb. 13 [cited 2024 Jun. 19];15(1):56-62. Available from: https://he01.tci-thaijo.org/index.php/jtss/article/view/172120

Issue

Section

Case Report