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Anemia in patients with Takayasu arteritis: prevalence, clinical features, and treatment

Journal of Geriatric Cardiology 2019年第9期16卷 689-694页

作者： Ying ZHANG Di ZHANG Yi QU Peng FAN Ya-Xin LIU Hui-Min ZHANG Lei SONG Wen-Jun MA Hai-Ying WU Jun CAI Fang LUO Xian-Liang ZHOU De-Yu ZHENG Li-Sheng LIU Department of Cardiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Background Anemia is a common comorbidity of patients with Takayasu arteritis(TA). This study evaluated the prevalence, clinical characteristics, and treatment in Chinese TA patients with anemia. Methods This retrospective study included 533 consecutive patients hospitalized for TA from January 2009 to April 2018. Anemia was diagnosed on the basis of hemoglobin level, according to World Health Organization criteria. Results A total of 194 patients(36.4%) were diagnosed with anemia. Most had mild anemia(177, 91.2%). Female patients were predominant(92.8% of anemic patients). Normocytic anemia(62.9%) was the most common pattern. Anemic patients were more likely than non-anemic patients to have dizziness(29.4% vs. 21.2%), low body mass index(22.0 ± 3.6 vs. 22.9 ± 3.4 kg/m2), and active disease stage(64.9% vs. 50.1%);pulmonary involvement(12.4% vs. 26.8%), pulmonary hypertension(12.9% vs. 20.1%) and pulmonary hypertensive-target drugs(2.8% vs. 11.6%) were less common among anemic than non-anemic patients(all P < 0.05). Larger left ventricular end-diastolic diameter and lower left ventricular ejection fraction were observed in anemic patients. Over a median follow-up of four months, the increase of hemoglobin in anemic patients was associated with the use of iron supplementation. Conclusions Anemia is a very common concurrent condition in TA, especially in young, female patients. Patients with anemia are more likely to be in the active disease stage. Iron supplementation helps increase hemoglobin.

关键词： Anemia Disease activity Oral iron supplementation Takayasu arteritis

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Drug coated balloon angioplasty for renal artery stenosis due to Takayasu arteritis: Report of five cases

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World Journal of Clinical Cases 2019年第18期7卷 2888-2893页

作者： Yong-Hua Bi Jian-Zhuang Ren Meng-Fei Yi Jin-Dong Li Xin-Wei Han Department of Interventional Radiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina Department of Thoracic Surgery the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina

BACKGROUND Takayasu arteritis is a rare but intractable chronic disease in young female patients. Percutaneous transluminal angioplasty of the involved renal arteries has been reported;however, few studies have reported the use of drug coated balloon angioplasty in the treatment of Takayasu arteritis. We aimed to demonstrate five young female patients who presented with a history of hypertension due to Takayasu arteritis. CASE SUMMARY From April 2017 to October 2018, five female patients were diagnosed with hypertension due to Takayasu arteritis by computed tomography angiography (CTA) and laboratory tests. Four patients had a complaint of headache with or without dizziness, and one patient showed no symptom. There was no significant family or past history of hypertension or kidney disease, and the physical examinations were almost normal on admission. We performed a treatment by drug coated balloon angioplasty. Blood pressure decreased dramatically in all patients after balloon angioplasty, and the patency of treated renal artery was demonstrated with CTA over 5 months after the angioplasty procedure. CONCLUSION Drug coated balloon angioplasty is safe and effective for renal artery stenosis due to Takayasu arteritis. A prospective study with a larger sample size is necessary to further demonstrate the effectiveness of the treatment.

关键词： Hypertension Renal artery stenosis Takayasu arteritis Balloon angioplasty Case report

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Tuberculosis in Takayasu arteritis: a retrospective study in 1105 Chinese patients

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Journal of Geriatric Cardiology 2019年第8期16卷 648-655页

作者： Ying ZHANG Peng FAN Fang LUO Hui-Min ZHANG Lei SONG Wen-Jun MA Hai-Ying WU Jun CAI Lin-Ping WANG Xian-Liang ZHOU Department of Cardiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Background Tuberculosis (TB) infection has been reported to have a possible relationship with the occurrence and clinical course of Takayasu arteritis (TA). We aimed to describe the characteristics of TB in a large population of TA patients. Methods We included a total of 1105 patients with TA, who were hospitalized between January 1992 and December 2017. Comparisons of clinical features were made according to the presence of TB. Results Among the 1105 patients, 109 (9.9%) had TB, including 53 patients (48.6%) diagnosed with TB before the onset of TA, 23 (21.1%) with a concurrent diagnosis of TB and TA, and 24 patients (22.0%) who developed TB after TA. Pulmonary TB was the most frequently identified (97 patients, 89.0%). Patients with TB had more frequent involvement of the pulmonary artery and experienced more chest discomfort and constitutional symptoms but had less interventional treatment. Demographic characteristics, comorbid diseases, and use of steroids were similar between patients with and without TB. Conclusions The proportion of Chinese TA patients with TB was not low, and about half of the patients had TB before TA. Pulmonary TB was the most common. Pulmonary artery involvement and pulmonary hypertension was more frequent in TA patients with TB.

关键词： Immunosuppressive agents Mycobacterium tuberculosis Pulmonary artery Takayasu arteritis

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Pneumonia and ocular disease as the primary presentations of Takayasu arteritis:a case report

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International Journal of Ophthalmology(English edition) 2023年第7期16卷 1167-1169页

作者： Dong-Ming Xu Department of Emergency Medicine Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

Dear Editor,Takayasu arteritis(TA)is a rare,idiopathic,granulomatous,large-vessel vasculitis,with preferential involvement of the aorta,its main branches,and pulmonary arteries[1].It has been reported that the ocular involvements were found in 8.1%–68%[2],non-specific arthralgia or myalgia in 13%–41%,aortic regurgitation in 5%–55%.

关键词： involvement ocular arteritis

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Anemia in Chinese patients with Takayasu arteritis

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中国循环杂志 2018年第S1期33卷 145-146页

作者： Ying Zhang Peng Fan Fang Luo Xianliang Zhou Department of Cardiology National Center for Cardiovascular DiseasesFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Objective Anemia as a concomitant disease of patients with Takayasu arteritis (TA) has been reported in several case reports, but epidemiological studies of large populations are lacking. This study evaluated the prev... 详细信息

关键词： Takayasu arteritis case reports

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A complicated case of innominate and right common arterial aneurysms due to Takayasu’s arteritis

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World Journal of Clinical Cases 2019年第13期7卷 1671-1676页

作者： Wen-Da Wang Rui Sun Meng-Xin Zhou Xing-Rong Liu Yue-Hong Zheng Yue-Xin Chen Department of Vascular Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China Department of Cardiac Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China

BACKGROUND Innominate artery aneurysms (IAAs) are relatively rare. Endovascular therapy has been an alternative to open surgery in some IAA cases, but open repair is still necessary in complicated cases. CASE SUMMARY We report a 35-year-old female who suffered from Takayasu’s arteritis. The patient did not get regular treatment, and IAA and right common carotid artery aneurysm developed, which complicated with occlusion of the left carotid artery, subclavian artery, and the initial part of the left vertebral artery. The patient also had moderate aortic valve insufficiency. With inflammation being controlled well, the patient received the surgery for arterial aneurysms of innominate and right common carotid arteries and aortic valve insufficiency. The shunts for cerebral blood supply were designed to protect the brain and the surgery was conducted successfully under extracorporeal circulation. CONCLUSION The case illustrates that open surgery may be appropriate for some complicated IAAs, and brain protection is important.

关键词： Case report Innominate artery aneurysm Takayasu's arteritis Shunts Brain protection

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Giant cell arteritis: Current treatment and management

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World Journal of Clinical Cases 2015年第6期3卷 484-494页

作者： Cristina Ponte Ana Filipa Rodrigues Lorraine O'Neill Raashid Ahmed Luqmani Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences Botnar Research Centre University of Oxford Oxford OX1 2JD United Kingdom Department of Rheumatology Hospital de Santa Maria CHLN Lisbon Academic Medical Centre 1649-035 Lisbon Portugal Department of Internal Medicine Hospital das Caldas da Rainha Centro Hospitalar Oeste 2500-176 Caldas da Rainha Portugal Department of Rheumatology St Vincent’s University Hospital Dublin Ireland

Glucocorticoids remain the cornerstone of medicaltherapy in giant cell arteritis(GCA) and should be started immediately to prevent severe consequences of the disease, such as blindness. However, glucocorticoid therapy leads to significant toxicity in over 80% of the patients. Various steroid-sparing agents have been tried, but robust scientific evidence of their efficacy and safety is still lacking. Tocilizumab, a monoclonal IL-6 receptor blocker, has shown promising results in a number of case series and is now being tested in a multi-centre randomized controlled trial. Other targeted treatments, such as the use of abatacept, are also now under investigation in GCA. The need for surgical treatment is rare and should ideally be performed in a quiescent phase of the disease. Not all patients follow the same course, but there are no valid biomarkers to assess therapy response. Monitoring of disease progress still relies on assessing clinical features and measuring inflammatory markers(C-reactive protein and erythrocyte sedimentation rate). Imaging techniques(e.g., ultrasound) are clearly important screening tools for aortic aneurysms and assessing patients with largevessel involvement, but may also have an important role as biomarkers of disease activity over time or in response to therapy. Although GCA is the most common form of primary vasculitis, the optimal strategies for treatment and monitoring remain uncertain.

关键词： Giant cell arteritis Therapy Disease management Glucocorticoids Immunosuppressive agents

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Crohn's disease and Takayasu's arteritis: An uncommon association

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World Journal of Gastroenterology 2013年第35期19卷 5933-5935页

作者： Andrea Taddio Massimo Maschio Stefano Martelossi Egidio Barbi Alessandro Ventura Institute of Child Health IRCCS "Burlo Garofolo" Trieste and University of Trieste Institute of Child Health IRCCS "Burlo Garofolo"

Takayasu’s arteritis(TA)and Crohn’s disease(CD)are two rare autoimmune disorders;however some reports describe the presence of both diseases in the same patient.This finding has suggested the possibility that both diseases could share some common etiologic origin.We describe a case of a 13-year-old male affected by CD characterized by fever,diarrhea,weight loss,abdominal pain and elevation of inflammatory markers.Clinical and histological features from colonic specimens were consistent with CD.Treatment with steroids and azathioprine was started,however disease flared every time steroids were tapered.One year later,while still on treatment,he came back to our attention for dyspnea at rest and at night,tiredness and weakness.At physical examination a diastolic heart murmur was found as well as a left carotid artery bruit.A transthoracic echocardiography showed mild aortic valve insufficiency,left ventricular hypertrophy and a dilated ascending aorta with same findings at the aortic arch.A computed tomography scan showed abdominal aortathickening,dilated thoracic aorta and the presence of a thoracic aortic aneurysm.TA associated with CD was diagnosed and medical treatment with cyclophosphamide,steroids and aminosalicylic acid was started,with good clinical response at 6 mo follow-up.We discuss the presence of possible common causes for the two diseases and the importance of differential diagnosis in those patients characterized for intractable disease.

关键词： Crohn’s disease Takayasu arteritis Intractable inflammatory bowel disease children Treatment

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Takayasu’s arteritis-aphasia as an initial presentation

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Neuroimmunology and Neuroinflammation 2016年第1期3卷 192-195页

作者： Davinder Singh Rana Anuradha Batra Ish Anand Samir Patel Pooja Gupta Department of Neurology Old building blockSir Ganga Ram HospitalOld Rajinder NagarNew Delhi 110060India

Takayasu arteritis(TA)is an uncommon disease of young women,characterized by granulomatous vasculitis of medium and large arteries.Neurological involvement is reported in only a minority of patients and occurrence of neurological syndromes as the first manifestation of disease has been rarely reported.We present clinical,laboratory and imaging findings of a 40 years old lady with TA,who initially presented with clinical manifestations of stroke in form of aphasia.The rarity of the disease and especially such a presentation can cause considerable delay in the diagnosis and treatment.

关键词： Takayasu arteritis stroke aphasia

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Malignancy in Chinese patients with Takayasu arteritis

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中国循环杂志 2018年第S1期33卷 145-145页

作者： Ying Zhang Fang Luo Xianliang Zhou Department of Cardiology National Center for Cardiovascular DiseasesFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Objective Takayasu arteritis(TA)is a kind of large vessel vasculitis of unknown reason.Autoimmune disorder was perhaps one of the risk factors.Cancer was related to autoimmune disease.This study aimed to describe the ... 详细信息

关键词： Takayasu arteritis risk factors autoimmune disease

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