Service de rhumatologie et centre des maladies osseuses, département de l'appareil locomoteur, hôpital orthopédique, 4, avenue Pierre-Decker, 1011 Lausanne, Switzerland.
Joint Bone Spine. 2013 Mar;80(2):211-3. doi: 10.1016/j.jbspin.2012.07.015. Epub 2012 Sep 19.
Takayasu's arteritis is a granulomatous, large vessel vasculitis that affects the aorta, its major branches and the pulmonary arteries. Compelling evidence exists to support the notion that Takayasu's arteritis is a T-cell mediated process and that tumor necrosis factor alpha (TNFa) is an important factor in the pathogenesis of this disease. Moreover, encouraging results from recent studies support the use of anti-TNFa therapy for relapsing or resistant cases of Takayasu's arteritis. Here, however, we describe the case of two patients: one with seropositive rheumatoid arthritis, the other with HLA-B27 negative spondylarthropathy, who developed Takayasu's arteritis during treatment with TNFa inhibitors (adalimumab and golimumab respectively). This is the first report of Takayasu's arteritis in rheumatic patients under TNFa blocking agents which suggests the presence of different pathogenetic mechanism in a subgroup of patients with Takayasu's arteritis, as well as a potential role of TNFa blockers as triggers of this disease in some cases.
Takayasu 动脉炎是一种累及主动脉、其主要分支和肺动脉的肉芽肿性大血管炎。有确凿的证据支持 Takayasu 动脉炎是一种 T 细胞介导的过程，肿瘤坏死因子-α（TNFα）是该病发病机制中的一个重要因素。此外，最近的研究结果令人鼓舞，支持在复发性或难治性 Takayasu 动脉炎病例中使用抗 TNFα 治疗。然而，在这里我们描述了两例患者的病例：一例为血清阳性类风湿关节炎，另一例为 HLA-B27 阴性脊柱关节病，他们在接受 TNFα 抑制剂（阿达木单抗和戈利木单抗）治疗期间发生了 Takayasu 动脉炎。这是 TNFα 阻滞剂治疗的风湿性疾病患者中首次报告 Takayasu 动脉炎，这表明在 Takayasu 动脉炎患者的亚组中存在不同的发病机制，以及在某些情况下 TNFα 阻滞剂可能作为该病的触发因素。
