On average it takes 44 months from onset of symptoms to diagnose Takayasu arteritis. Because of its rarity and the often subtle physical findings, Takayasu arteritis frequently fails to enter the differential diagnosis for patients with fever of unknown origin (FUO). Thus it is critical to consider Takayasu arteritis in patients under 40 with FUO, aortic regurgitation, hypertension, or absent pulses. Rarely, patients older than 40 years of age meet the criteria for Takayasu arteritis because of a prolonged pre-diagnostic period or late onset of symptoms. In this case, giant cell arteritis may be indistinguishable from Takayasu arteritis; however, initial treatment for both is nearly identical ...
TY - JOUR. T1 - Concurrent takayasu arteritis with common variable immunodeficiency and moyamoya disease. AU - Skeik, Nedaa. AU - Rumery, Kyle K.. AU - Udayakumar, Prabhu D.. AU - Crandall, Benjamin M.. AU - Warrington, Kenneth J.. AU - Sullivan, Timothy M.. PY - 2013/2. Y1 - 2013/2. N2 - Takayasu arteritis is a rare, chronic form of large vessel vasculitis that characteristically involves the aorta and its branches. Its origin and disease process are currently unknown, although T lymphocytes and, most recently, B cells are thought to play a role. Common variable immunodeficiency (CVID) is a collection of heterogeneous disorders resulting in an antibody deficiency and recurrent infections, and is the most common symptomatic primary immunodeficiency disorder. This report presents a unique case of possible Takayasu arteritis with a history of CVID in a young man admitted with multiple cerebrovascular accidents. Takayasu arteritis may serve as the main cause of this presentation. The rarity of this ...
TY - JOUR. T1 - Subclavian steal syndrome secondary to Takayasu Arteritis in a young female Caucasian patient. AU - Tsivgoulis, Georgios. AU - Heliopoulos, Ioannis. AU - Vadikolias, Konstantinos. AU - Birbilis, Theodosios. AU - Piperidou, Charitomeni. PY - 2010/9/15. Y1 - 2010/9/15. N2 - Subclavian steal syndrome (SSS) is most frequently described in Caucasians aged over 50 years because of increased incidence of atherosclerosis in this population. Non-atherosclerotic etiologies of SSS are rare in Caucasians. We present a case of Subclavian Steal Syndrome secondary to Takayasu Arteritis (TA) in a 26 year-old female Caucasian patient. The present case underscores that despite the very low incidence of TA in Caucasians (0.8/1,000,000), this large-vessel vasculitis of unknown etiology should always be considered in the differential diagnosis of subclavian steal syndrome in Caucasian women aged less than 40 years.. AB - Subclavian steal syndrome (SSS) is most frequently described in Caucasians aged ...
Takayasu arteritis is a chronic inflammatory disease of the aorta and its major branches. The disorder is a large vessel vasculitis of unknown origin that most often affects young women in the second and third decades of life (see the image below).
A 9-year-old girl presented with cervical mass 2 months before heart failure. Her grandfather had died of tuberculosis 6 years previously. Tuberculous lymphadenitis was proved by biopsy of a neck mass, and chest radiography revealed no pulmonary tuberculosis or cardiomegaly (A). She developed heart failure and cardiomegaly (B) 1 month after the initiation of an antituberculosis regimen.. Echocardiography revealed a dilated left atrium and left ventricle with decreased left ventricular ejection fraction (35%). Computed tomography showed severe discrete stenosis in the thoracic aorta, with the narrowest diameter measured as 3 mm (C, D). The diagnosis of Takayasu arteritis was established because the patient had evident angiographic abnormalities, high blood pressure at the bilateral upper extremities (150/96 mm Hg), an undetectable pulse at the bilateral lower extremities, and bruit over the aorta (1-3). Methylprednisolone was administered for 4 weeks, but heart failure and aortic stenosis did not ...
Vessel imaging in Takayasu arteritis (TAK) is often performed in clinical practice following laboratory test abnormalities or clinical symptoms, such as limb claudication. Conversely, the association between limb claudication and vessel imaging manifestations has not been assessed. This observational, cross-sectional study analyzed 139 adult TAK patients from 2000 to 2018. Their arterial vessel imaging information (especially significant stenosis and occlusion data) was registered and crosschecked with clinical and laboratory data. When vessel imaging was performed, the median age and disease duration of the patients were 38 (27.3-47.0) and 5.0 (1.0-12.0) years, respectively. There was no association between arterial abnormalities and demographic data, constitutional symptoms or laboratory parameters. Limb claudication was reported in 42 patients (30.2%): 17.3% reported it in the upper left limb (ULL), 12.2% reported it in the upper right limb (URL), 12.9% reported it in the lower left limb ...
Lien vers Pubmed [PMID] - 28412700. J. Rheumatol. 2017 Jul;44(7):1011-1017. OBJECTIVE: Spondyloarthritis (SpA) and Takayasu arteritis (TA) are 2 chronic inflammatory diseases; their coexistence in a single patient is uncommon. The aims of our study were to describe clinical features of patients having SpA associated with TA and to identify some characteristics of the types of patients with SpA associated with TA. We also analyzed treatments used in this context.. METHODS: This French multicenter retrospective survey called for observations on behalf of the Club Rhumatismes et Inflammations, with a standardized questionnaire established by the investigators.. RESULTS: We included 14 patients (women: 10/14; median age at SpA diagnosis: 43.5 yrs, ranging from 19 to 63). Subtypes of SpA were ankylosing spondylitis (n = 11), psoriatic arthritis (n = 2), and synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome (n = 1). HLA-B27 was positive in 3 cases, negative in 9, and unknown in 2. SpA ...
Rosenberg IL, Jarjour WN. Rosenberg I.L., Jarjour W.N. Rosenberg, Irving L., and Wael N. Jarjour.GIANT CELL AND TAKAYASU ARTERITIS. In: Dean SM, Satiani B, Abraham WT. Dean S.M., Satiani B, Abraham W.T. Eds. Steven M. Dean, et al.eds. Color Atlas and Synopsis of Vascular Diseases New York, NY: McGraw-Hill; 2014. http://accesscardiology.mhmedical.com/content.aspx?bookid=1201§ionid=71015746. Accessed February 23, 2018 ...
Takayasus arteritis is a chronic inflammatory condition that affects the aorta, the largest blood vessel in the body, and its branches. Inflammation causes segments of the vessels to become narrowed, blocked, or even stretched, possibly resulting in aneurysms. The disease is very rare but most commonly occurs in young Asian women. Symptoms may include arm pain with use, decreased or absent pulses, lightheadedness or dizziness, headaches, and visual disturbances. Many individuals with Takayasu arteritis, however, have no apparent symptoms despite disease activity. Additionally, current tests used to measure vessel inflammation are considered unreliable and inconsistent. It is therefore very difficult to determine the extent of disease activity in a person with Takayasus arteritis. This study will use novel scientific methods to establish new biomarkers that can be used to monitor disease activity in individuals with Takayasus arteritis. These biomarkers may be used to help direct clinical ...
OMERACT is an independent initiative of international rheumatology health professionals interested in the development and validation of outcome measures in rheumatic diseases. Individual OMERACT groups hold consensus conferences every two years. The ongoing work of this OMERACT group has been to employ a data-driven approach to developing a core set of domains to shape standardized outcome measures for clinical trials of large vessel vasculitis treatments.. The comprehensive review of the literature conducted by this working group several years ago demonstrated a lack of standardized outcome measures for large vessel vasculitis.2,3 No broadly accepted definitions of important outcomes, such as disease activity or response to therapy, exist, Dr. Aydin explains. She also notes randomized controlled trials conducted for treatments targeting large vessel vasculitis diseases, such as Takayasus arteritis and giant cell arteritis, have usually based definitions of relapse and remission on the presence ...
Introduction: Takayasus arteritis (TA) is a rare systemic, chronic inflam-matory, progressive, idiopathic disease of aorta and its main branches. Taka-yasus arteritis causes narrowing, occlusion and aneurysm of arteries. The eti-ology of TA is still unknown. It may be autoimmune or genetic in origin or infective diseases. It is commonly found in Asia and oriental countries. Worldwide annual incidence is 1.2 - 2.6 cases/million. Women are affected in 80% - 90% of cases with age of onset below 40 years. TA does not worsen or improve with pregnancy but has adverse effect on pregnancy in the form of abortion, Intrauterine fetal death, superimposed preeclampsia, Intrauterine growth restriction, abruption and congestive heart failure. Because the disease is common in women of childbearing age, management of pregnancy in these patients becomes important; however optimal management for pregnant pa-tients with this disease has not yet been established. Due to the manifold car-diovascular complications that can
DOI: http://dx.doi.org/10.5915/20-4-13298. A middle-aged male patient is described who suffered left hemiplegia because of occlusion of the brachiocephalic and right common carotid artery. He was found to have Takayasus Arteritis. An in-depth review of the history of arteritis, especially as related to nosology, is presented. Literature is reviewed with emphasis on the neurologic and cardiovascular manifestations. Etiology and pathology are briefly discussed.. ...
BACKGROUND: The present paper reports the preliminary experience with surgical treatment of 49 cases of cerebral ischaemia caused by cervical arterial lesions due to Takayasus arteritis (TA). METHODS: Six men and 43 women were treated between June 1
Takayasus arteritis is a chronic granulomatous vasculitis of unknown cause characterized by stenosis, occlusion, and aneurysm of large elastic arteries, mainly the aorta and its branches. It mainly affects young women, predominantly in Asian, Middle Eastern, and South American countries.Clinical presentation-symptoms in the acute stage are nonspecific, such as general fatigue and fever, which can persist for months to years. Symptoms in the chronic stage depend on the anatomical location of the vascular lesions, with typical complaints relating to ischaemia of the brain, eyes, or arms. The commonest finding on physical examination is a weak or absent pulse in one or both brachial, radial, and/or ulnar arteries. Bruits can often be heard over affected arteries. Hypertension and aortic insufficiency are strongly associated with poor prognosis.Diagnosis-comprehensive angiographic imaging is required for diagnosis, evaluation of the extent of disease, and to guide therapy. American College of Rheumatology
Takayasus arteritis is a chronic granulomatous vasculitis of unknown cause characterized by stenosis, occlusion, and aneurysm of large elastic arteries, mainly the aorta and its branches. It mainly affects young women, predominantly in Asian, Middle Eastern, and South American countries.. Clinical presentation-symptoms in the acute stage are nonspecific, such as general fatigue and fever, which can persist for months to years. Symptoms in the chronic stage depend on the anatomical location of the vascular lesions, with typical complaints relating to ischaemia of the brain, eyes, or arms. The commonest finding on physical examination is a weak or absent pulse in one or both brachial, radial, and/or ulnar arteries. Bruits can often be heard over affected arteries. Hypertension and aortic insufficiency are strongly associated with poor prognosis.. Diagnosis-comprehensive angiographic imaging is required for diagnosis, evaluation of the extent of disease, and to guide therapy. American College of ...
Takayasus arteritis is a chronic granulomatous vasculitis of unknown cause characterized by stenosis, occlusion, and aneurysm of large elastic arteries, mainly the aorta and its branches. It mainly affects young women, predominantly in Asian, Middle Eastern, and South American countries.. Clinical presentation-symptoms in the acute stage are nonspecific, such as general fatigue and fever, which can persist for months to years. Symptoms in the chronic stage depend on the anatomical location of the vascular lesions, with typical complaints relating to ischaemia of the brain, eyes, or arms. The commonest finding on physical examination is a weak or absent pulse in one or both brachial, radial, and/or ulnar arteries. Bruits can often be heard over affected arteries. Hypertension and aortic insufficiency are strongly associated with poor prognosis.. Diagnosis-comprehensive angiographic imaging is required for diagnosis, evaluation of the extent of disease, and to guide therapy. American College of ...
BUETTEL, Aloísio Cerqueira; CASTRO, Roberto Monteiro de; CHAVES, Itagyba Martins Miranda and GONCALVES, Luiz Henrique. Continuous epidural anesthesia for cesarean section in a patient with Takayasu s arteritis: case report. Rev. Bras. Anestesiol. [online]. 2002, vol.52, n.3, pp.326-329. ISSN 0034-7094. http://dx.doi.org/10.1590/S0034-70942002000300007.. BACKGROUND AND OBJECTIVES: Continuous epidural anesthesia with titrated doses of local anesthetics is safe and effective for patients not tolerating blood pressure fluctuations. This report aimed at presenting a case in which continuous epidural anesthesia for Cesarean section in a patient with Takayasu s arteritis was successfully induced. CASE REPORT: Primiparous patient, 25 years old, 63 kg, Takayasu s arteritis, 34 to 35 weeks of gestation, acute fetal distress, blood pressure = 155/85, HR = 92, no carotid, upper and right lower limb pulse. Patient had only left palpable popliteal pulse. Epidural continuous anesthesia was induced with 25 mg ...
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Tumor necrosis factor (TNF) is the most important in the formation of granulomas. The granulomatous nature of the histopathologic lesion in TA led us to consider an evaluation of the therapeutic benefits of anti-TNF therapy in patients with refractory TA.. In our study five children (5 girls) aged from 10 to 17 years with widespread inflammation in the aorta and its main branches were treated with infliximab during 6 months. The mean duration of the disease was 4.5 years. All patients received oral steroids and methotrexate or cyclophosphamide. The cause for anti-TNF treatment was standart therapy tolerance and uncontrolled arterial hypertension. Patients were tested for tuderculosis by skin test and chest roentgenography. Also we excluded active systemic infections, neutropenia, thrombocytopenia and liver dysfunction. ...
Takayasu arteritis is a granulomatous panarteritis that predominantly affects the aorta and its major branches. The initial manifestations of this large-vessel vasculitis are usually nonspecific; however, as the disease progresses, typical symptoms of arterial occlusion, aneurysmal formation, and vascular pain become evident. Ischemic ocular complications of Takayasu arteritis which could lead to complete loss of vision are not uncommon and depend on the obliterated portion(s) of carotid(s), the intensity and rate of progression of ocular vascular insufficiency, and sufficiency of the collateral blood supply to the eye. A 24-year-old woman of African descent with prior normal vision was referred to us with a 3-year history of gradual decline in visual acuity in both eyes and unintentional weight loss (17 kg) within the past 1 year. A physical examination revealed feeble brachial and radial arterial pulses on her left side. She had sinus tachycardia (136 beats/minute) and her blood pressure was 85/59
Takayasu Arteritis is a vasculitis occurring mostly in young females which may present in diverse ways. Here we report a teenager with Takayasu Arteritis who presented with uncontrolled hypertension. This case depicts an atypical presentation of this
This study is the first double-blind, randomised controlled trial of anti-cytokine therapy for the treatment of patients with TAK. It was designed to investigate whether tocilizumab treatment enables GC tapering. Investigating the efficacy of therapeutic agents in TAK is challenging because no efficacy endpoint has been validated. Kerrs definition of active disease3 has been used in case reports and cohort studies,11 16 21 23 28-30 but the requirement for imaging studies such as CT, MRI and/or positron emission tomography places a greater burden on patients in terms of exposure and risk from contrast dyes, and it may not be possible to perform imaging for every suspected relapse. Therefore, this study adopted a definition of relapse that was based on the signs and symptoms of TAK without imaging evaluations.. The current study was designed to evaluate time to relapse of TAK with mandatory GC tapering. To induce remission, patients who experienced relapse received GCs at a dose at least twice ...
We used FDG-PET/CT to assess TA disease activity, because this modality can identify sites of accelerated metabolism indicative of an inflammatory reaction, and max SUV can be used to quantitatively represent the degree of inflammation. Our present results thus support the concept that max SUV provides a valid means of comparing patients with active and inactive TA. We examined whether changes in blood glucose levels and venous mean SUV would impact the validity of our arterial max SUV data but found that these data did not differ between active and inactive TA.. Webb et al. (5) were the first to report the diagnostic accuracy of FDG-PET in 18 TA cases. Their SE was 92%, and SP was 100%. Disease activity was determined by a combination of clinical symptoms of TA in this report. Kobayashi et al. (10) were the first to establish a cutoff for max SUV in their study of 14 TA patients. Their SE was 90.9%, and SP was 88.8%, but they defined active disease as a clinical requirement for prednisolone. ...
Results A total of 184 patients with TA were identified. The mean age at diagnosis was 35.3±16.4 years and 160 (87.2%) were female. Forty-four (23.9%) patients underwent open surgery and 25 (13.6%) patients underwent a percutaneous endovascular intervention. After median follow-up of 20.1±1.4 years, 17 (38.6%) patients in the open surgery group and 11 (44%) patients in the percutaneous intervention group developed significant restenosis requiring a second intervention (Fig. 1). The use of corticosteroid, azathioprine or cyclophosphamide did not affect restenosis rate (HR=0.77, 95% CI: 0.3-2.0). Nor did disease activity or traditional cardiovascular risk factors such as diabetes and hypertension (P,0.05). However, use of methotrexate was associated with a higher risk of significant restenosis (HR=2.48, 95% CI 1.074-5.747).. ...
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Learn about Takayasu disease, a chronic inflammation of the aorta. Takayasu disease symptoms include dizziness, headaches, chest pain, and abdominal pain.
Statistiche di Mappa - Arterite di Takayasu - Controlla come questa condizione influisce sulla vita quotidiana delle persone che ne soffrono.
A 16-year-old boy who was a non-smoker presented with a prolonged severe dry cough and malaise of 3 months in duration. Despite an increase in the patients inflammatory marker levels, no respiratory lesions were radiologically or serologically detected. We suspected that the cough reflex pathway had been stimulated by large vessel vasculitis (a non-respiratory inflammatory condition) and diagnosed the patient with Takayasu arteritis. While inflammation of either the ascending pharyngeal or pulmonary artery have been reported to cause cough in patients with large vessel vasculitis, the present case shows that intense inflammation of the aortic arch and the starting portion of its main branches may stimulate a vagus nerve branch as a novel mechanism causing cough ...
PubMed comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
CONCLUSIONS: TAK does co-occur with IBD, AS and less frequently with BS in about 1/5 of the patients, at least in a hospital setting. There is no clear temporal pattern. The high prevalence of inflammatory back pain in the dorsal spine in TAK needs further scrutiny. PMID: 31969224 [PubMed - as supplied by publisher]...
Case Reports in Obstetrics and Gynecology is a peer-reviewed, Open Access journal that publishes case reports in all areas of obstetrics and gynecology.
Full Papers; Authors: C. Arslan>, C. Tel>, B. Arapi>, S. Esatoglu>, K. Besirli>, A. Bozkurt>, V. Hamuryudan>, H. Tuzun>, E. Seyahi>
Subclavian steal syndrome" or in translation Subclavian steal syndrome is a phenomenon that occurs due to stenosis or occlusion of the subclavian artery as a result of atherosclerosis. The syndrome includes specific retrograde blood flow in the vertebral artery, which tries to ensure the needs of the upper extremities for which "steals" blood cerebral circulation. Except atherosclerosis, the other causes of Subclavian steal syndrome are: Takayasu arteritis, giant cell arteritis, congenital anomalies of large blood vessels, surgery syndrome and compression of the thorax. Risk factors are: smoking, hypercholesterolemia, diabetes mellitus, hypertension and homocysteinemia. Prevalence appearance of subclavian steal syndrome is 0.6-6.4% and affects in most cases left subclavian arteries. It occurs in adulthood after 50s and more often in men than in women in the ratio 2: 1. Classification syndrome is determined by the areas from which blood was "stolen" (vertebral-vertebral, carotid-basilar, external ...
OBJECTIVE: To retrospectively evaluate the clinical features, angiographic findings, and outcomes of children with Takayasu arteritis (TA) in Turkey. METHODS: Clinical, laboratory, and angiographic findings and outcomes of 19 children with TA were evaluated with a retrospective chart review. The criteria for inclusion were those proposed by the American College of Rheumatology. RESULTS: Mean followup period was 35.89 +/- 40.75 months (range 1-168, median 30). There were 14 girls and 5 boys. The mean age at diagnosis was 12.84 +/- 2.69 years (range 8-17, median 13). The most common complaints on admission were headache (84%), abdominal pain (37%), claudication of extremities (32%), fever (26%), and weight loss (10%). One patient presented with visual loss. Examination on admission revealed hypertension (89%), absent pulses (58%), and bruits (42%). Angiography revealed type I in 13 patients (aortic arch, descending thoracic, and abdominal aorta), type II in 4 (descending thoracic aorta and ...
Symptoms of Arteritis including 5 medical symptoms and signs of Arteritis, alternative diagnoses, misdiagnosis, and correct diagnosis for Arteritis signs or Arteritis symptoms.
TY - JOUR. T1 - Multiple nonatherosclerotic aneurysms unrelated to a clinical syndrome. AU - Meyer, D. M.. AU - Fry, R. E.. AU - Snyder, W. H.. AU - Fry, W. J.. PY - 1990/1/1. Y1 - 1990/1/1. N2 - Two cases of multiple inflammatory aneurysms in young patients without evidence of autoimmune disease or an aneurysmal syndrome are presented. Neither case showed any clinical or histologic characteristics typical of Ehlers-Danlos syndrome, Marfans syndrome, Takayasus arteritis, or other aneurysmal syndromes. Pathologic findings showed adventitial and medial destruction in both patients; although the first case displayed more adventitial involvement, the second showed greater destruction of the medial elastic laminae. The decision to repair an aneurysm should be tempered by its location, the amount of involvement of the artery with multiple lesions, and the risk to the end-organ if repair is unsuccessful.. AB - Two cases of multiple inflammatory aneurysms in young patients without evidence of ...
16. Podocalyxin is a glycoprotein ligand of the human pluripotent stem cell-specific probe rBC2LCN, Stem Cells Transl Med, 2巻, 4号, 265頁 ~ 273頁, 2013年03月22日, Tateno, H., A. Matsushima, K. Hiemori, Y. Onuma, Y. Ito, K. Hasehira, K. Nishimura, M. Ohtaka, S. Takayasu, M. Nakanishi, Y. Ikehara, M. Nakanishi, K. Ohnuma, T. Chan, M. Toyoda, H. Akutsu, A. Umezawa, M. Asashima and J. Hirabayashi. ...
Learn more about Arteritis Temporal at Portsmouth Regional Hospital DefiniciónCausasFactores de riesgoSíntomasDiagnósticoTratamientoPrevenció...
methylprednisolonum, tableta, ATC H02AB04, SmPC (Sažetak opisa svojstava lijeka) Terapijske indikacije: Medrol tablete su indicirane u stanjima koja zahtijevaju terapiju glukokortikoidima kao što su: Endokrini poremećaji: primarna i sekundarna adrenalna insuficijencija kongenitalna adrenalna hiperplazija Reumatske bolesti: reumatoidni artritis juvenilni kronični artritis ankilozantni spondilitis Kolagene bolesti / arteritis: sistemski lupus eritematozus H A L M E D sistemski dermatomiozitis (...
Id start with the power pac worming protocol (5 days double dose Safe Guard and Quest plus 10 days after your last day is what I do). Info on that and the problems associated in the link here. http://www.littleoasisequine.com/uploads/2/1/7/6/21760604/osteopathy_and_verminous_arteritis.pdf Edited to ...
TY - JOUR. T1 - Renal manifestations in toddlers with Takayasus arteritis and malignant hypertension. AU - Hijazi, Rana. AU - Chandar, Jayanthi. AU - Nwobi, Obioma. AU - Muneeruddin, Samina. AU - Zilleruelo, Gastón. AU - Abitbol, Carolyn L.. PY - 2009/1/1. Y1 - 2009/1/1. N2 - Three children under the age of 3 years presented with malignant hypertension, proteinuria, and acute kidney injury. Takayasus arteritis was diagnosed on the basis of clinical symptoms of weight loss and low grade fever in conjunction with elevated sedimentation rate and radiographic evidence of aortic and renal artery stenosis. One patient had a renal biopsy which showed arteriolar sclerosis and focal glomerulosclerosis. All three patients required multiple antihypertensive agents, ultimately including angiotensin receptor blockers and/or angiotensin converting enzyme inhibitors. The vasculitis was treated with pulse corticosteroids followed by cyclophosphamide in one patient and mycophenolate mofetil as maintenance ...
Background/Purpose: A key unmet need in the monitoring of disease activity in large vessel vasculitides (LVV), i.e., giant cell arteritis (GCA) and Takayasu arteritis (TAK), is the ability to differentiate active vasculitic disease activity from atherosclerotic damage through the use of noninvasive imaging modalities. In LVV, the inflammatory process begins at the vasa vasorum in the adventitia, with vasa vasoritis and inflammatory cell recruitment. Thickened adventitia and medial fibrosis are key features that differentiate vasculitis from atherosclerosis. A novel imaging modality that can noninvasively detect increased neovascularization and thickening in large vessels adventitia is microbubble contrast-enhanced carotid ultrasonography (CU). In animal and human studies using CU, higher densities of vasa vasorum correlated with plaque vulnerability and atherosclerosis progression. Our objective was to establish feasibility of measuring adventitial vasa vasorum density (aVVD) in LVV patients; ...
18F-flurodeoxyglucose (FDG) positron emission tomography (PET) provides information about vascular inflammation that is complimentary to, and unique from, clinical assessment in large-vessel vasculitis (LVV), a recent study found. Furthermore, FDG-PET scan activity during clinical remission was associated with future clinical relapse. Patients with Takayasus arteritis (TAK) and giant cell arteritis (GCA) were studied, along with a comparator group consisting of patients with hyperlipidemia, diseases that mimic LVV, and healthy controls.
HLA-B52 (B52) is an HLA-B serotype. The serotype identifies the more common HLA-B*52 gene products. B52 is a split antigen of the broad antigen B5, and is a sister type of B51. B*5201 likely formed as a result of a gene conversion event between another HLA-B allele and HLA-B*5101. There are a number of alleles within the B*52 allele group. There are 18 alleles, with 14 amino acid sequence variants in B52. Of these only 9 are frequent enough to have been reliably serotyped. B*5201 is the most common, but others have a large regional abundance. HLA-B52 appears to have the strongest linkage to ulcerative colitis in Japan. This form of disease is frequently found with Takayasus arteritis. Takayasus arteritis appears to have an independent link to B52 associated disease. The association with B*5201 increases risk of pulmonary infarction, ischemic heart disease, aortic regurgitation, systemic hypertension, renal artery stenosis, cerebrovascular disease, and visual disturbance. Marsh SG, Albert ED, ...
Colour Doppler ultrasound displays a pathognomonic circumferential wall thickening in large-vessel vasculitis. Even rather small arteries like the temporal arteries can be easily examined with modern ultrasound equipment. In addition, ultrasound can detect stenoses and acute arterial occlusions. In large-vessel giant cell arteritis, the axillary arteries are most commonly involved. Takayasu arteritis affects particularly the left subclavian and the left common carotid arteries. As ultrasound diagnosis at the temporal arteries becomes more difficult already after a few days of glucocorticoid treatment in some patients, institutions are implementing fast-track clinics for which patients receive an appointment within 24 hours. An experienced rheumatologist is able to establish a definite diagnosis in most cases with standardised history, clinical examination and ultrasound of temporal and axillary arteries. Furthermore, early diagnosis and treatment may prevent blindness ...
My clinical research interests include systemic vasculitis (Wegeners granulomatosis, microscopic polyangiitis, giant cell arteritis, Takayasu arteritis) and multi-disciplinary efforts in the areas of systemic lupus erythematosus and anti-phospholipid syndrome. Dr. E. William St.
A 40-year-old man was admitted with symptomatic pulmonary stenosis in Takayasu arteritis. Computed tomographic pulmonary angiography demonstrated no blood flow in the left lung and a severe narrowing in the right main pulmonary artery (Figure 1). Pulmonary angiography showed reduced perfusion in the right lung (Figure 2A). Balloon pulmonary angioplasty (BPA) was attempted in the right pulmonary artery, but BPA was ceased because the patient had a seizure during balloon dilation. We suspect that the seizure was triggered by transient loss of blood flow in the brain during balloon dilation, which blocked the only pulmonary artery that connected the right heart and the lungs. To maintain pulmonary blood flow during balloon angioplasty, a 6-F long introducer sheath was advanced to the right pulmonary artery and successfully crossed the lesion to deliver blood, which was collected from the patients atria and anticoagulated with heparin before BPA. The blood was then injected using syringes at a ...
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