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Takayasu 动脉炎致动脉性高血压。病例报告及文献复习。

Takayasu arteritis as a cause of arterial hypertension. Case report and literature review.

机构信息

Department of Pediatric Cardiology, Medical University of Lublin, ul. Chodźki 2, 20-093 Lublin, Poland.

出版信息

Eur J Pediatr. 2012 May;171(5):863-9. doi: 10.1007/s00431-012-1674-z.

Abstract

UNLABELLED

We report a 16-year-old girl in whom Takayasu arteritis (TA) was manifested mainly by severe arterial hypertension on her right arm, which was detected during a routine examination at school. Her systolic blood pressure on the right arm was significantly higher than that on the left one. There was also a pressure difference between the right arm and legs. The pulse of the left external carotid artery and that of the left radial artery was absent. Vascular bruits over interscapular and right supra- and subclavian areas were heard on auscultation. The diagnosis of TA was confirmed by a spiral computed tomography angiography, which showed a thickened thoracic aortic wall and narrowing of its lumen. In addition, complete occlusion of the left common carotid artery and the left subclavian artery was observed.

CONCLUSION

The rarity of the disorder and the heterogeneous nature of its clinical manifestation predispose to a late diagnosis and delayed treatment. Our report highlights the fact that the condition can and does occur in a pediatric population in Europe and hence must be considered in patients presenting with suggestive symptoms and signs, especially in young patients with unexplained hypertension. Clinical suspicion and proper imaging are crucial for the correct diagnosis and management of patients with TA. A brief review of literature completes this report.

摘要

目的:报告 1 例主要表现为右臂重度动脉高血压的青少年大动脉炎(TA)患者,该患者在学校常规体检时被发现。右臂收缩压明显高于左臂,且右臂与腿部之间存在血压差异。左颈外动脉和左桡动脉脉搏消失。听诊时可闻及肩胛间区、右锁骨上区和锁骨下区血管杂音。经螺旋 CT 血管造影证实 TA 诊断,显示胸主动脉壁增厚,管腔狭窄。此外,还观察到左颈总动脉和左锁骨下动脉完全闭塞。

结论:该病罕见且临床表现多样,易导致诊断延迟和治疗延误。本病例报告强调了在出现可疑症状和体征的患者中,尤其是在年轻的不明原因高血压患者中,该病可能且确实会发生在欧洲的儿科人群中,因此必须考虑该病的可能。临床怀疑和适当的影像学检查对于 TA 患者的正确诊断和管理至关重要。本文简要回顾了相关文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bfd/3327834/189f70711523/431_2012_1674_Fig1_HTML.jpg

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