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Takayasu动脉炎合并克罗恩病的罕见病例。

Rare case of Takayasu's arteritis associated with Crohn's disease.

作者信息

Kusunoki Ryusaku, Ishihara Shunji, Sato Mariko, Sumita Yoshiko, Mishima Yoshiyuki, Okada Mayumi, Tada Yasumasa, Oka Akihiko, Fukuba Nobuhiko, Oshima Naoki, Moriyama Ichiro, Yuki Takafumi, Sato Shuichi, Amano Yuji, Murakawa Yohko, Kinoshita Yoshikazu

机构信息

Department of Internal Medicine II, Shimane University School of Medicine, Japan.

出版信息

Intern Med. 2011;50(15):1581-5. doi: 10.2169/internalmedicine.50.5406. Epub 2011 Aug 1.

Abstract

Takayasu's arteritis (TA) and Crohn's disease (CD) are chronic inflammatory diseases of uncertain etiology. Although co-existence of these rare diseases is estimated to occur in 1 in 10 billion individuals, a theoretically unexpected association has been reported in several patients and it is suggested that those associations may have been more than an unusual coincidence. Herein, we report a case of TA associated with clinically inactive CD. A Japanese woman was diagnosed with colonic CD at the age of 15, developed aortic valve regurgitation at 19, and then presented with general fatigue, low grade fever, and painful sensations in her left arm at 25. She was diagnosed with TA based on computed tomography scanning and magnetic resonance angiography findings, and treatments with prednisolone and cyclosporine were started. Thereafter, valve replacement and right coronary artery bypass graft surgery were performed. The possible pathophysiological mechanism responsible for concurrent existence of TA and CD may be associated with immune disorders. Early diagnosis of vascular lesions for patients with inflammatory bowel disease is highly encouraged.

摘要

高安动脉炎(TA)和克罗恩病(CD)是病因不明的慢性炎症性疾病。虽然估计这两种罕见疾病同时存在的几率为百亿分之一,但已有报道称在数例患者中出现了理论上意想不到的关联,提示这些关联可能并非仅是异常巧合。在此,我们报告1例合并临床静止期CD的TA患者。1名日本女性15岁时被诊断为结肠CD,19岁时出现主动脉瓣反流,25岁时出现全身乏力、低热及左臂疼痛。根据计算机断层扫描和磁共振血管造影结果,她被诊断为TA,并开始使用泼尼松龙和环孢素治疗。此后,进行了瓣膜置换和右冠状动脉搭桥手术。TA和CD并存的可能病理生理机制可能与免疫紊乱有关。强烈建议对炎症性肠病患者早期诊断血管病变。

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