Takayasu Arteritis
Review of diagnostic and therapeutic criteria in relation to a clinical case
Abstract
A case report of a woman carrier of Takayasu arteritis with coronary injuries is presented. The patient reached five out of six criteria of the American College of Rheumatology and five out of seven diagnostic criteria of Ishikawa.The woman was admitted to the hospital because of coronary symptoms with unstable angor of high risk. She underwent cineangiocoronarygraphy that showed significant coronary injuries; two stents were implanted in the affected arteries.The association between injuries and atherosclerotic degenerative disease was analyzed due to the profusion of vascular risk factors seen in the patient: diabetes, hypertension, dyslipidemia and smoking.
Clinical history is adjusted to a predominance of inflammatory over degenerative injuries since we considered a coexistence of both diseases.
Post corticosteroid treatment follows up coincided with our findings: dramatic improvement in general conditions, decrease of erythrocyte sedimentation rates, and anemia improvement.
Vascular injuries improvement was not demonstrated, there was no significant difference between prior and post steroid treatment aortography. This is congruent with international experience since injuries have a scared fibrous component, without improvement under antimflammatory treatment.
References
2) Sato E, Lima D, Espirito Santo B, Hata F. Takayasu arteritis: Treatment and prognosis in an university center in Brazil. Int J Cardiol 2000; 75(Suppl 1): S163-6.
3) Bali H, Jain S, Jain A, Sharma B. Stent supported angioplasty in Takayasu arteritis. Intern J Cardiol 1998; 66(Suppl 1): S213-7.
4) Espinola-Zavaleta N, Soto M, Bauk L, Miguel Casanova J, Keirns C, Avila Vanzzini N, et al. Coronary reserve in Takayasu’s arteritis: transesophageal echocardiographic analysis. Echocardiography 2005; 22(7): 593-8.
5) Arend W, Michel B, Bloch D, Hunder G, Calabrese L, Edworthy S, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 1990; 33(8): 1129-34.
6) Ishikawa K. Diagnostic approach and proposed criteria for the clinical diagnosis of Takayasu’s arteriopathy. J Am Coll Cardiol 1988; 12(4): 964-72.
7) Park M, Lee S, Park Y, Chung N, Lee S. Clinical characteristics and outcomes of Takayasu’s arteritis: analysis of 108 patients using standardized criteria for diagnosis, activity assessment, and angiographic classification. Scand J Rheumatol 2005; 34(4): 284-92.
8) Mwipatayi B, Jeffery P, Beningfield S, Matley P, Naidoo N, Kalla A, et al. Takayasu arteritis: clinical features and management: report of 272 cases. ANZ J Surg 2005; 75(3): 110-7.
9) Andrews J, Al-Nahhas A, Pennell DJ, Hossain MS, Davies KA, Haskard D, et al. Non-invasive imaging in the diagnosis andmanagement of Takayasu’s arteritis. Ann Rheum Dis 2004; 63(8): 995-1000.
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