Pulmonary hypertension in Takayasu arteritis
Authors:
M. Škvařilová 1; J. Lindner 2; B. Hanzová 3; J. Dušková 3; P. Jansa 1; T. Paleček 1; M. Aschermann 1
Authors place of work:
Centrum pro plicní arteriální hypertenzi II. interní kliniky kardiologie a angiologie 1. lékařské fakulty UK a VFN v Praze, přednosta prof. MUDr. Aleš Linhart, DrSc.
1; II. chirurgická klinika 1. lékařské fakulty UK a VFN v Praze, přednosta doc. MUDr. Jan Tošovský, CSc.
2; Ústav patologie 1. lékařské fakulty UK a VFN v Praze, přednosta prof. MUDr. Cyril Povýšil, DrSc.
3
Published in the journal:
Vnitř Lék 2007; 53(1): 71-77
Category:
Case Reports
Summary
Takayasu arteritis (TA) is a rare chronic vasculitis primarily involving the aorta and its main branches. The disease affects women much more frequently than men, the ratio being 8: 1. The onset occurs in the teenage years, always before age of 40. Aortic regurgitation is rare. The pulmonary artery stenosis may also rarely occur. We report the case of a 49-year old female patient with Takayasu arteritis who presented with severe left pulmonary trunk stenosis resulting in pulmonary hypertension, severe aortic regurgitation due to the dilatation of the ascending aorta, mitral insufficiency, critical left renal artery stenosis, and probably with left main coronary artery stenosis. No severe stenosis or occlusion in the mid portion of mid subclavian artery lesion were present. Because the patient presented with serious congestive heart failure, she underwent mitral valvuloplasty and aortic valve replacement. However, the patient died in early postoperative period due to pulmonary hypertension which failed to respond to pharmacotherapy.
Key words:
pulmonary hypertension – Takayasu arteritis – aorta – aortic regurgitation
Zdroje
1. Procter CD, Holier LH. Takayusu’s arteritis and temporal arteritis. Ann Vasc Surg 1992; 6: 195-199.
2. Kerr G, Hallahan CW, Giordano J et al. Takayusu’s arthritis Ann Intern Med 1994; 120: 919-929.
3. Braunwald E. Heart disease. 5th ed. Philadephia: WB Saunders 1997: 1571-1572.
4. Lupi-Herrera E, Sanches-Tores G, Marcushamer J et al. Takayusu’s arteritis: Clinical study of 107 cases. Am Heart J 1977; 93: 94-103.
5. Cirillo LR. www.eMedicine.com: June, 2005; Takayasu’s arthritis.
6. Braunwald E. Heart disease. 5th ed. Philadephia: WB Saunders 1997: 1575.
7. Podhola M. Obrovskobuněčná granulomatózní aortitida a plicní arteritida. Česk Patol 1996; 32: 31-33.
8. Akikusa B, Kondo Y, Muraki N. Aortic insufficiency caused by Takayusu’s aortitis without usual clinical features. Arch Pathol Lab Med 1981; 105: 650-668.
9. Wu YJ, Martin B, Ong K et al. Takayusu’s arteritis as a cause of fever of unknown origin. Am J Med 1989; 64: 87-92.
10. Judge RD, Currier RD, Gracie WA. Takayusu’s arthritis and the aortic arch syndrome. Am J Med 1962; 32: 379-385.
11. Vanoli M, Miani S, Amft N et al. Takayusu’s arteritis in Italian patients. Clin Exp Rheumatol 1995; 13: 45-50.
12. Kioysawa M, Baba T. Ophthalmological findings in patients with Takayasu’s disease. Int J Cardiol 1998; 66(Suppl 1): S141-S147.
13. Fava MP, Foradori GB, Garcia CB et al. Percutaneous transluminal angioplasty in patients with Takayasu’s arthritis. J Vasc Interv Radiol 1993; 4(5): 649-652.
14. Kerr G Takayusu’s aortitis. Curr Opin Rheumatol 1994; 6: 32-38.
15. Numano F. Differences in clinical presentation and outcome in different countries for Takayasu’s arthritis. Curr Opin Rheumatol 1997; 9: 12-15.
16. Jejeda C, Correa P. Non-syphilitic aortitis. Arch Patology 1969: 87: 177-181.
17. Hoch J, Janík V, Zelenková V. Takayusova artritida. Vnitř Lék 1993; 39(8): 773-777.
18. Malik IS, O’Harare, Al-Nahae A et al. Takayusu’s arthritis: management of left main stem stenosis. Heart 2003: 89: 9.
19. Cipriano PR, Silverman JF, Perlroth MG et al. Coronary arterial narrowing in Takayusu’s arthritis. Am J Cardiol 1977: 39: 744-750.
20. Jolliet P, Bulpha P, Athorens JB et al. Nitric oxide and prostacyclin as test agents of vasoreactivity in severe precapillary pulmonary hypertension predictive ability and consequences on hemodynamics and gas exange. Thorax 1997; 52: 369-372.
21. Paul JF, Fiessinger JN, Sapoval M. Follow up electron beam CT for the management of early phase Takayusu’s arthritis. J Comput Assist Tomogr 2001; 25: 924-931.
22. Kumar S, Radharkrishnan S, Phadke RV. Takayusu’s arthritis: Evaluation with three- dimense time-of-flight MR angiography Eur Radiol 1997; 7: 44-50.
23. Ishikava K, Maetani S Long term outcome for 120 Japanese patients with Takayusu’s disease. Circulation 1994; 90: 1855-1862.
24. Hall B, Barr W, Lie JT et al. Takayusu’s arteritis. A study of North American patients. Medicine 1985; 64: 89-95.
25. Bongard O, Schneider PA, Krahenbuhl B et al. Transluminal angioplasty of the aorta, renal and mesenteric arteries in Takayusu’s arthritis. Eur J Vas Surg 1992; 6: 567-571.
26. Sharma S, Gusta H, Saxena A et al. Results of renal angioplasty in nonspecific aortoarteritis (Takayusu’s disease). J Vasc Interv Radiol 1998; 9(3): 429-435.
27. Shelhamer JH, Volkman JE, Parillo JE. Takayusu’s arthritis and its therapy. Ann Intern Med 1985; 103: 121-126.
28. Contran RS, Kumar V, Robbins SL. Pathologic Basis of Disease. 5th ed. Philadelphia: WB Saunders 1994: 489-499.
29. Ravelli A, Pedroni E, Perrone S et al. Aortic valve regurgitation as the presenting sign of Takayusu’s arteritis. Eur J Pediatr 1999; 158: 281-283.
Štítky
Diabetology Endocrinology Internal medicineČlánok vyšiel v časopise
Internal Medicine
2007 Číslo 1
Najčítanejšie v tomto čísle
- The FEVER (Felodipine EVEnt Reduction) trial; a randomised, double-blind, placebo-controlled trial in Chinese hypertensive patients
- Guidelines for pharmacotherapy of acute and chronic non-oncological pain
- The importance of determination of Nt-proBNP and big endothelin in diagnosing chronic heart failure in patients on regular haemodialysis treatment
- Epilepsy and disorders of reproduction