Takayasu’s Arteritis with Renovascular Damage: A Case Report

Takayasu’s arteritis characterizes with severe damage of medium- and large-sized arteries. The pathophysiological progression of full-thickness inflammation of the vessel wall and subsequent fibrosis usually occurs with vascular stenosis and/or occlusion, causing ischemia of the corresponding organs, which is associated with high mortality. the suppression of vascular and systemic inflammation is a major aspect of medical treatment. Glucocorticoids (GC) have been the cornerstone of treatment in TA induction. The remission rate of GC mono-therapy is as high as 60%. However, nearly 80% of patients develop progressive or alternating (recurrence and remission) forms of TA. The current case report focuses on a Asian middle-aged woman who complained pain in arms, headache, cardiodynia, nausea, edema in lower extremities, low appetite, high blood pressure, loss of physical activity, malaise, and fatigue for as many as 6 years. Deferred diagnosis and lack of specific treatment could explain the severity of the arterial injury at time of hospital admission. Angiography showed multiple narrowing and atherosclerosis of the abdominal and thoracic aorta, unilateral occlusion of the subclavian artery, unilateral occlusion of the common carotid artery, stenosis of the celiac trunk, superior mesenteric artery, bilateral renal arteries, enlarged pulmonary trunk, and unilateral hypoplasia of the left kidney. Early diagnosis and treatment is warranted. Outcome appears to be favorable when the disease is quiescent. Renovascular damage and hypertension is usually resistant to medical therapy and frequently requires complex therapy with invasive management methods, such as angioplasty or surgical bypass.

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