Department of Pediatric Cardiology, 2nd Chair of Pediatrics and Cardiology, Medical University of Lodz, Lodz, Poland.
Rheumatol Int. 2012 Nov;32(11):3655-9. doi: 10.1007/s00296-010-1518-y. Epub 2010 May 15.
Takayasu's arteritis (TA) rarely occurs in infants. There are only four reports on TA in children below 1 year of age, revealing diversity of its symptoms. We describe a 7-month-old female infant hospitalized for hectic fever, irritability, high acute phase indices, and coronary artery dilatations found on echocardiography, which suggested Kawasaki disease (KD). Despite of standard treatment, rapid development of thoracic and abdominal aorta aneurysms occurred, while coronary artery abnormalities regressed. The initial diagnosis was changed for TA. Subsequently implemented glucocorticosteroids led to clinical and laboratory normalization. However, 2 months after treatment discontinuation, TA relapsed. Glucocorticosteroid therapy was restarted with additional introduction of intravenous immunoglobulins (IVIG), resulting in full and stable remission lasting over 1 year. Thus, diagnosis and treatment of infant TA pose a big challenge to physicians. TA onset in infants may mimics KD. Prolonged glucocorticosteroids and IVIG administration can be recommended in the youngest patients with TA.
Takayasu 动脉炎（TA）在婴儿中很少见。仅有 4 篇关于 1 岁以下儿童 TA 的报道，揭示了其症状的多样性。我们描述了一例 7 月龄女性婴儿，因高热、烦躁、急性期指标升高，且超声心动图提示冠状动脉扩张而住院，这提示川崎病（KD）的可能。尽管接受了标准治疗，但仍迅速出现胸主动脉和腹主动脉瘤，而冠状动脉异常则消退。最初的诊断更改为 TA。随后使用糖皮质激素治疗后，临床和实验室指标恢复正常。然而，停药后 2 个月，TA 复发。重新开始糖皮质激素治疗，并加用静脉注射免疫球蛋白（IVIG），治疗后完全缓解且稳定，持续 1 年以上。因此，婴儿 TA 的诊断和治疗对医生来说是一个巨大的挑战。婴儿 TA 发病可能与 KD 相似。对于最小的 TA 患儿，建议长时间使用糖皮质激素和 IVIG 治疗。
