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一名35岁女性患高安动脉炎并出现大面积脑缺血性梗死:病例报告

Takayasu arteritis presenting with massive cerebral ischemic infarction in a 35-year-old woman: a case report.

作者信息

Gao Shan, Wang Ruilan

机构信息

Intensive Care Unit, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, 650 Xinsongjiang Road, Shanghai 201620, China.

出版信息

J Med Case Rep. 2013 Jul 5;7:179. doi: 10.1186/1752-1947-7-179.

Abstract

INTRODUCTION

Takayasu arteritis is a relatively rare type of large-vessel arteritis that primarily affects the aorta and its major branches, the coronary arteries, and the pulmonary arteries. Depending on the different groups of blood vessels involved in the disease process, the clinical presentation of Takayasu arteritis varies. Here we report a case of a woman presenting with a debilitating massive cerebral ischemic infarct that turned out to be a relatively rare first presentation of Takayasu arteritis.

CASE PRESENTATION

A 35-year-old Chinese woman presented to the Emergency Department with left hemiparesis, pain and numbness of her arms and weak radial pulses. Her laboratory results showed an elevated C-reactive protein and erythrocyte sedimentation rate, and subsequent digital subtraction angiography demonstrated narrowing and occlusion of the major branches of her aortic arch. We report the case of a patient with Takayasu arteritis presenting with a massive cerebral ischemic infarct and review the current literature on this topic.

CONCLUSION

Takayasu arteritis is a relatively rare disease with various and sometimes devastating clinical manifestations, such as massive cerebral ischemic infarction as in our case. Currently, there are multiple diagnostic tools and treatment options available, and more under investigation. Early, appropriate diagnosis and initiation of proper therapy could avoid further progression and reduce complications of the disease.

摘要

引言

高安动脉炎是一种相对罕见的大血管动脉炎,主要累及主动脉及其主要分支、冠状动脉和肺动脉。根据疾病过程中受累血管组的不同,高安动脉炎的临床表现各异。在此,我们报告一例女性患者,其表现为严重的大面积脑缺血梗死,结果证明这是高安动脉炎一种相对罕见的首发表现。

病例介绍

一名35岁的中国女性因左侧偏瘫、手臂疼痛和麻木以及桡动脉搏动减弱就诊于急诊科。她的实验室检查结果显示C反应蛋白和红细胞沉降率升高,随后的数字减影血管造影显示其主动脉弓主要分支狭窄和闭塞。我们报告一例患有高安动脉炎并出现大面积脑缺血梗死的患者病例,并回顾关于该主题的当前文献。

结论

高安动脉炎是一种相对罕见的疾病,具有多样且有时具有破坏性的临床表现,如我们病例中的大面积脑缺血梗死。目前,有多种诊断工具和治疗选择,还有更多正在研究中。早期、恰当的诊断和启动适当的治疗可以避免疾病的进一步进展并减少并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5089/3707746/6273c300433f/1752-1947-7-179-1.jpg

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