Peredo Rubén, Vilá Salvador, Goñi Michelle, Colón Edgar, Ríos-Solá Grissel
Department of Internal Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
J Clin Rheumatol. 2005 Oct;11(5):270-3. doi: 10.1097/01.rhu.0000182193.58384.77.
A woman with Takayasu arteritis is reported who presented with constitutional symptoms and persistent thrombocytosis documented since 3 years before the diagnosis. Disease-specific symptoms such as arm claudication, transient loss of vision, and self-remitting eye ptosis present at the time were apparently missed, because she is a non-English-speaking Hispanic woman whose history was obtained through an interpreter. Extensive workup done at the time failed to reach a definite etiology. A computed tomography scan of the chest done because of midthoracic back pain and an elevated erythrocyte sedimentation rate showed circumferential wall thickening and mild surrounding edema throughout the thoracic and abdominal aorta and both carotid arteries consistent with Takayasu arteritis. Prednisone at a dosage of 1 mg/kg twice a day decreased the platelet count within 45 days of its initiation. Takayasu arteritis should be considered in the differential diagnosis of unexplained thrombocytosis, particularly in young women.
本文报告了一名患有高安动脉炎的女性，她在诊断前3年就出现了全身症状和持续的血小板增多症。当时出现的诸如手臂间歇性跛行、短暂视力丧失和自行缓解的眼睑下垂等疾病特异性症状显然被漏诊了，因为她是一名不会说英语的西班牙裔女性，其病史是通过翻译获取的。当时进行的广泛检查未能明确病因。因胸中部背痛和红细胞沉降率升高而进行的胸部计算机断层扫描显示，整个胸主动脉、腹主动脉和双侧颈动脉均有环形壁增厚和轻度周围水肿，符合高安动脉炎的表现。每天两次、剂量为1mg/kg的泼尼松在开始使用后45天内使血小板计数下降。在不明原因血小板增多症的鉴别诊断中，尤其是年轻女性，应考虑高安动脉炎。
