Department of Cardiology, Fukuoka University Hospital, Fukuoka 814-0180, Japan.
J Cardiol. 2008 Jun;51(3):196-200. doi: 10.1016/j.jjcc.2007.12.003. Epub 2008 Apr 24.
Takayasu's arteritis has often been difficult to diagnose because of a lack of typical symptoms and other specific makers. We report here a case of Takayasu's arteritis in a 73-year-old man who was considered to exhibit isolated pulmonary artery involvement. Pulmonary hypertension and right heart failure and severe stenosis in the main trunk and left pulmonary artery were observed. There was nothing remarkable in his routine blood-sample tests other than increased CRP and ESR. There were neither infectious nor collagen diseases. Anti-cardiolipin antibody, Antiphospholipid Syndrome, PR3-ANCA and MPO-ANCA were negative. We diagnosed the patient as having Takayasu's arteritis based on chronic inflammation and the morphologic features of pulmonary artery lesion. However, other large vessels and the aorta were not involved. Treatment was started with glucocorticoids. The symptoms gradually improved, and pulmonary artery pressure estimated by echocardiography decreased along with inflammatiory markers. There were no remarkable changes in the stenotic lesions in the pulmonary artery but the flow limit in the left pulmonary artery was improved.
Takayasu 动脉炎由于缺乏典型症状和其他特定标志物，常常难以诊断。我们在此报告一例 73 岁男性 Takayasu 动脉炎病例，该患者被认为仅存在肺动脉受累。观察到肺动脉高压和右心衰竭以及主肺动脉干和左肺动脉严重狭窄。除 CRP 和 ESR 升高外，常规血样检查无明显异常。既无感染性疾病也无胶原病。抗心磷脂抗体、抗磷脂综合征、PR3-ANCA 和 MPO-ANCA 均为阴性。我们根据慢性炎症和肺动脉病变的形态学特征诊断该患者为 Takayasu 动脉炎。然而，其他大动脉和主动脉未受累。治疗开始使用糖皮质激素。症状逐渐改善，超声心动图估计的肺动脉压随着炎症标志物的降低而降低。肺动脉狭窄病变无明显变化，但左肺动脉血流受限得到改善。
