Besson-Léaud L, Grenier N, Besson-Léaud M, Boniface C, Guillard J M
Département de pédiatrie médicale, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France.
Arch Pediatr. 2001 Jul;8(7):724-7. doi: 10.1016/s0929-693x(00)90305-1.
Takayasu's disease is a nonspecific aortic arteritis that affects mostly young women and sometimes children. Usual treatment consists of early and prolonged steroids. Some patients do not respond to this treatment, become steroid-dependent or suffer from side effects. We report a case in which methotrexate proved to be effective.
A 6-year-old girl presented with Takayasu's disease with elevated blood pressure of renovascular origin. Corticosteroids controlled the inflammatory syndrome but not the renal involvement and stopped the growth. Methotrexate (10 mg/m2/week) resulted in the control of the disease, the reduction of steroids and normal growth.
In Takayasu's disease, steroids should be given as first-line therapy. In case of failure, side effects or steroid dependency, small doses of methotrexate may facilitate the disease's control and weaning from the steroids.