Four cases of Takayasu's disease in female Arabs are reported. All patients had classical features of the disease. Typing for HLA phenotype showed that all patients had HLA A2, A9, BW35 and DR7 antigens, suggesting an immunogenetic basis for the disease. As far as we know, this is the first report of Takayasu's disease in this ethnic group. (+info)
Surgical treatment of Takayasu's disease.
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Thirty-nine patients (mean age: 33 years) with Takayasu's disease were observed over the past 8 years. Among these patients, 33 had surgical intervention with a mean follow-up of 4 years. Lesions of the aortic arch were the most common (29 patients, 69 lesions) and frequently were associated with lesions in another site as well. However, in this group of patients, the infrequent presence of signs of cerebral vascular insufficiency limited the number of suitable surgical candidates to 14 patients. Lesions of the renal arteries were noted in 25 patients (37 lesions) and were associated with coarctation of the thoracoabdominal aorta in 12 patients. In contrast to lesions of the aortic arch, the presence of severe hypertension was a frequent indication for surgery in Takayasu's disease. Twenty-one patients had operation. Twenty of 21 patients were considered cured or improved of hypertension. The one patient who received no benefit was the only operative death of the study. In conclusion, although Takayasu's disease is progressive and the life expectancy is foreshortened, hypertension secondary to aortic and renal artery lesions is a frequent and important indication for aggressive operative treatment. (+info)
Regression of carotid stenoses after corticosteroid therapy in occlusive thromboaortopathy (Takayasu's disease).
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A 34-year-old, single Japanese woman with active Takayasu's disease presented with stenosed bilateral common carotid arteries, subtotal occlusion of the left subclavian artery, and complete occlusion of the ipsilateral proximal vertebral artery, as demonstrated by angiography. A right subclavian-left vertebral bypass using an autologous saphenous vein graft was successfully performed after 36 days of corticosteroid therapy. Subsequently, warfarin was administered in addition to prednisolone. After 32 months of treatment with a gradual reduction from 50 to 3.75 mg of prednisolone daily, angiography revealed a functioning bypass graft and regression of bilateral common carotid stenoses. (+info)
Seronegative spondarthritis associated with Takayasu's arteritis.
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A young woman presented with an aortic arch syndrome a few years after the onset of ankylosing spondylitis. Tissue typing showed HLA-B27. The possibility of an association between ankylosing spondylitis and Takayasu's arteritis is suggested. (+info)
Diagnostic approach and proposed criteria for the clinical diagnosis of Takayasu's arteriopathy.
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The criteria proposed for the clinical diagnosis of Takayasu's disease (chronic inflammatory arteriopathy of unknown origin) were based on clinical and angiographic data from 108 Japanese patients: 96 with Takayasu's disease and 12 with another disease of the aorta. The criteria consist of one obligatory criterion (age less than or equal to 40 years), two major criteria (left and right mid subclavian artery lesions) and nine minor criteria (high erythrocyte sedimentation rate, common carotid artery tenderness, hypertension, aortic regurgitation or annuloaortic ectasia and lesions of the pulmonary artery, left mid common carotid artery, distal brachiocephalic trunk, thoracic aorta and abdominal aorta). In addition to the obligatory criterion, the presence of two major criteria or of one major plus two or more minor criteria, or of four or more minor criteria suggests a high probability of the presence of Takayasu's disease. The criteria had an 84% sensitivity in 96 patients with this disease: 52 (96%) of 54 patients in the active young group, 8 (80%) of 10 in the active older group, 14 (67%) of 21 in the inactive young group and 7 (64%) of 11 in the inactive older group fulfilled the criteria; however, none of the 12 patients with other aortic diseases did so. Use of these criteria has shortened the delay of an accurate diagnosis in patients with Takayasu's disease. (+info)
Takayasu's arteritis as a differential diagnosis of systemic juvenile chronic arthritis.
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After a series of throat infections an 8-year-old girl presented with fever and limb pain, initially diagnosed as juvenile chronic arthritis. Persistent symptoms led to further investigations when she was shown to have an arteritis affecting her aorta. (+info)
Endocardial lesion in a case of Takayasu's arteriopathy.
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The clinical findings and the necropsy report of a 14-year-old girl suffering from Takayasu's arteriopathy have been presented. In addition to the typical arterial changes, thickening and puckering of the aortic valve and a patch of thickening in the left atrial endocardium were shown at necropsy. The histology of this lesion was found to be identical with the arterial intimal changes. It has been postulated that Takayasu's arteriopathy may rarely extend to the valvular and mural endocardium of the heart, producing cardiac murmurs. Similar cases with cardiac murmurs reported earlier and attributed to associated rheumatic endocarditis were probably due to the same pathological process extending to the endocarditis. (+info)
Non-specific arteritis ofhe aorta and its main branches.
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Four cases of non-specific arteritis involving the aorta and its main branches are described. Three of the cases were hypertensive and one of these had evidence of aortic incompetence. Cases 1, 2, and 3 had involvement of the aortic arch vessels and the descending aorta, whereas Case 4 presented as a coarctation of the abdominal aorta. There was a significant association with systemic disturbance such as polyarthritis, fever, weight loss, raised erythrocyte sedimentation rate, and hyperglobulinaemia. A detailed necropsy in Case 2 showed two large dissecting aneurysms. The nomenclature, the diagnostic criteria, and a probable pathogenesis of the disease are discussed with reference to the relevant published material. (+info)