Abstract
Takayasu‘s disease is a chronic idiopathic inflammatory disease that mainly affects large vessels. It is predominantly seen in young women whose symptoms may appear between 15 and 30 years of age. It is characterized by a lymphomonocytic infiltrate and presence of granulomas that progress to lumen reduction, giving rise to thrombotic phenomena. In order of frequency, subclavian (85 %), descending thoracic aorta (58 %), abdominal (20 %), vertebral (17 %), iliac (16 %), and pulmonary (15 %) vessels are mainly affected. Coronary artery involvement represents less than 10 % of cases. We present two cases with unusual location, an atypical presentation involving femoral and renal arteries, and vascular involvement in a previously hypertensive pregnant woman.References
(1) Pascual, E. V., Ivorra, J. A. R., Chalmeta, I., Gallego, J. M. S., & Sancho, J. J. A. Arteritis de Takayasu. Revista de la SVR : Sociedad Valenciana de Reumatología. 2006;2(4),25-27.
(2) Harty MP, Kramer S, Fellows KE. Current concepts on imaging of thoracic vascular abnormalities. Curr Opin Pediatr. Jun 2000;12(3);194-202.
(3) Arend WP, Michel BA, Bloch DA et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 1990;33:1129–34.
(4) Schmidt WA, Nerenheim A, Seipelt E, Poehls C, Gromnica- Ihle E. Diagnosis of early Takayasu arteritis with sonography. Oxford J Rheumatol. 2002; 41(5):194-202.
(5) Kissin EY, Merkel PA. Diagnostic imaging in Takayasu arteritis. Curr Opin Rheumatol. 2004;16(1): 31-37.
(6) Daina, E., Schieppati A., Remuzzi, G.. Mycophenolate Mofetil for the treatment of Takayasu Arteritis: report of three cases. Ann Intern Med. 1999;130(5):422-426.
(7) Mahlmann A, Pfluecke C, Simonis G, Weiss N, Kappert U. Combined immunosuppressive therapy including a TNF-alpha blocker induces remission in a difficult treat patient with Takayasu arteriitis and coronary involvement. Vasa. 2012; 41(6): 451-457.
(8) Terao, C. History of Takayasu arteritis and Dr. Mikito Takayasu. International journal of rheumatic diseases. 2014;17(8),931-935.
(9) Boubakar K, Kaaroud H, Goucha R, Kheder A. Lesión renal en la arteritis de Takayasu Artículo francés Nephrol Ther. 2014 ;10 (6): 451-6.
(10) Sharma, S., Saxena, A., Talwar, K. K., Kaul, U., Mehta, S. N., & Rajani, M. Renal artery stenosis caused by nonspecific arteritis (Takayasu disease): results of treatment with percutaneous transluminal angioplasty. AJR. American journal of roentgenology 1992, 158(2), 417-422.
(11) Matsumura A, Moriwaki R, Numano F - Pregnancy in Takayasu arteritis from the view of internal medicine. Heart Vessels, 1992;7(Suppl):120-124.
(12) Sharma BK, Sagar S, Singh AP, Suri S. Takayasu arteritis in India. Heart Vessels Suppl. 1992;7:37-43
(13) Ishikawa, K., Maetani, S. Long-term outcome for 120 Japanese patients with Takayasu‘s disease. Clinical and statistical analyses of related prognostic factors. Circulation 1994;90(4),1855-1860.
(14) Gulati A, Bagga A. Large vessel vasculitis. Pediatr Nephrol 2010;25:1037–1048.
(15) Conference on Comparative Studies of Takayasu Arteritis among Asian Countries. Tokyo, Japan. 1991. Heart Vessels Suppl. 1992;7:1-178.