Takayasu arteritis associated with tuberculosis: a case report
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20230401Keywords:
Pulseless disease, Takayasu Arteritis, Claudication, Tuberculosis, PTAAbstract
Takayasu arteritis, also called pulseless disease, is the chronic inflammation of the vessels, mainly the aorta and large vessels. It mainly affects females more than males with the ratio of 2.15:1 and in the second and third decade of life. Mechanism may be transmural fibrous thickening of the arterial walls. Takayasu’s is characterized by granulomatous inflammation of the vessel wall, leading to occlusion of the vessel wall. It is represented with claudication, fever, arthralgia. Clinical features are chest pain, vascular bruits, Hypertension. Investigation is based on angiography and CT scan. Medical treatment prednisolone is the first line agent 1mg/kg/day maximum dose is 60mg/day with gradual tapering as per European league against rheumatism guidelines, methotrexate and azathioprine are for inducing remission of arterial lesions, tumour necrosis factor-a antagonists, anti-IL-6 receptor monoclonal antibody like tocilizumab. Surgical treatment is angioplasty and stenting renal artery stenosis but less invasive and safest method is percutaneous transluminal angioplasty (PTA). Takayasu arteritis might be associated with Tuberculosis, yet, the relationship and mechanism are not clearly understood. Here we report a case of Takayasu arteritis associated with tuberculosis.
Metrics
References
Numano F, Okawara O, Inomata H, Kobayashi Y. Takayasu's arteritis. Lancet. 2000;356:1023-5.
Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, et al. Takayasu arteritis. Clinical study of 107 cases. Am Heart J. 1977;93:94-103.
Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, et al. Takayasu arteritis. Ann Intern Med. 1994;120:919-29.
Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol. 2002;55:481-6.
Brunner J, Feldman BM, Pascal N. Takayasu arteritis in children and adolescents. Rheumatology. 2010;49:1806-14.
Walker BR, Colledge NR. Davidson’s principles and practice of medicine. 2010;1116, 22nd edition.
Longo D, Fauci A, Kasper D, Hauser S, Jameson J, Loscalzo J. Harrison's principles of internal Medicine. 18th ed. New York, McGraw-Hill. 2011;2.
Subramanyan R, Joy J, Balakrishnan KG. Natural history of aortoarteritis Takayasu’s disease. Circulation. 1989;80:429-37.
Lupi-Herrera E, Sánchez-Torres G, Marcushamer J. Takayasu arteritis Clinical study of 107 cases. Am Heart J. 1977;93:94-103.
Hall S, Barr W, Lie JT. Takayasu arteritis A study of 32 North American patients. Medicine. 1985;64:89-99.
Tanigawa K, Eguchi K, Kitamura Y. Magnetic resonance imaging detection of aortic and pulmonary artery wall thickening in the acute stage of Takayasu arteritis Improvement of clinical and radiologic findings after steroid therapy. Arthritis Rheum. 1992;35:476-80.
Maksimowicz-McKinnon K, Clark TM, Hoffman GS. Limitations of therapy and a guarded prognosis in an American cohort of Takayasu arteritis patients. Arthritis Rheumatism. 2007;56(3):1000-9.
Mukhtyar C, Guillevin L, Cid MC. EULAR recommendations for the management of large vessel vasculitis. Ann Rheumatic Dis. 2009;68(3):318-23.
Unizony JHS, Stone JR. New treatment strategies in large vessel vasculitis. Curr Opinion Rheumatol. 2013;25(1):3-9.
Saadoun D Lamber M, Mirault T. Retrospective analysis of surgery versus endovascular intervention in Takayasu arteritis: a multicenter experience. Circulation. 2012;125:813-9.
Dev V, Shrivastava S, Rajani M Percutaneous transluminal balloon angioplasty in Takayasu’s aortitis: persistent benefit over two years. Am Heart J. 1999;120:222-4.
Hata A, Noda M, Moriwaki R, Numano F. Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol. 1996;54(1):S155-63.
Moriwaki R, Noda M, Yajima M. Clinical manifestations of Takayasu arteritis in India and Japan new classification of angiographic findings. Angiology. 1997;48:369-79.
Ishikawa K. Natural history and classification of occlusive thromboaortopathy Takayasu’s disease. Circulation. 1978;57:27-35.
Das D, Mondal KK, Ray B, Chakrabarti A. A case of unusual presentation of Takayasu's arteritis. Indian J Ophthalmol. 2010;58:148-50.
Suwanwela N, Piyachon C. Takayasu arteritis in Thailand: clinical and imaging features. Int J Cardiol. 1996;S117-34.
Jain S, Kumari S, Ganguly NK, Sharma BK. Current status of Takayasu arteritis in India. Int J Cardiol. 1996;S111-6.
Ueda H, Morooka S, Ito I, Yamaguchi H, Takeda T. Clinical observation of 52 cases of aortitis syndrome. Jpn Heart J. 1969;(4):277-88.
Sharma S, Gupta H, Saxena A, Kothari SS, Taneja K, Guleria S, et al. Results of renal angioplasty in nonspecific aortoarteritis (Takayasu disease). J Vasc Interv Radiol. 1998;(3):429-35.
Al-Aghbari K, Al-Motarreb A, Askar F. Takayasu′s arteritis associated with tuberculosis in a young Yemeni woman. Heart Views. 2010;11:117-20.
Muranjan MN, Bavdekar SB, More V, Deshmukh H, Tripathi M, Vaswani R. Study of Takayasu's arteritis in children: clinical profile and management. J Postgrad Med. 2000;46:3-8.
Tuberculosis. 2020. Available at: https://www.who.int/news-room/fact-sheets/detail/tuberculosis. Accessed on 20 Oct, 2022.
Lung health diseases. 2020. Available at: https://www.lung.org/lung-health-diseases/lung-diseaselookup/tuberculosis/learn-about-tuberculosis. Accessed on 20 October 2022.
