Yago Toru, Ota Shuji, Nishinarita Makoto
Division of Rheumatology, Tokyo Metropolitan Otsuka Hospital, Tokyo.
Ryumachi. 2002 Jun;42(3):605-9.
We report a case of systemic sclerosis complicated by Takayasu's arteritis. A 68-year-old woman had been treated for hypertension since 1984. She also had Raynaud's phenomenon and noticed vertigo and dizziness. In January 1992, she was diagnosed with back bruit. In April 1994, she was complicated by vertigo and diagnosed with asymmetrical blood pressure. In October 1998, she consulted our hospital because of neck bruit, abdominal bruit, back bruit and stenosis of descending aorta bifurcation on chest computed tomography. Her blood pressure was asymmetrical, being recorded as 190/101 on the right and 140/90 on the left. Scleroderma was observed from the finger to forehand, precordia, and face. Telangiectasia was observed on the precordia. Laboratory studies revealed the presence of anti-nuclear antibody (x 1280, discrete speckled.), anti-centromere antibody but anti-topoisomerasel antibody was negative. Skin biopsy from the left forehand detected proliferation of collgen fibers and perivascular inflammatory cell infiltration. A diagnosis of systemic sclerosis was made according to the American Rheumatism Association criteria. We suspected complication by Takayasu's arteritis because of asymmetrical blood pressure and bruit. Chest-abdominal angiography detected stenosis of the right brachiocephalic trunk, celiac artery, and left renal artery. We diagnosed Takayasu's arteritis. This is the second case report of a patient with systemic sclerosis complicated by Takayasu's arteritis.
我们报告一例系统性硬化症合并高安动脉炎的病例。一名68岁女性自1984年起接受高血压治疗。她还患有雷诺现象,并出现眩晕和头晕。1992年1月,她被诊断出背部有血管杂音。1994年4月,她并发眩晕,并被诊断为血压不对称。1998年10月,她因颈部血管杂音、腹部血管杂音、背部血管杂音以及胸部计算机断层扫描显示降主动脉分叉处狭窄而前来我院就诊。她的血压不对称,右侧记录为190/101,左侧为140/90。从手指到前臂、心前区和面部均观察到硬皮病。在心前区观察到毛细血管扩张。实验室检查发现存在抗核抗体(x1280,离散斑点状)、抗着丝点抗体,但抗拓扑异构酶1抗体为阴性。左前臂皮肤活检发现胶原纤维增生和血管周围炎性细胞浸润。根据美国风湿病协会标准诊断为系统性硬化症。由于血压不对称和血管杂音,我们怀疑合并高安动脉炎。胸腹血管造影检测到右头臂干、腹腔动脉和左肾动脉狭窄。我们诊断为高安动脉炎。这是系统性硬化症合并高安动脉炎患者的第二例病例报告。