Liebscher Felix, Pfammatter Thomas, Kolios Antonios, Greutmann Matthias, Franzen Daniel
Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
Respiration. 2017;93(3):207-211. doi: 10.1159/000454955. Epub 2017 Jan 21.
We report a rare case of Takayasu's arteritis with isolated pulmonary artery stenosis in the presence of active hepatitis B and latent Mycobacterium tuberculosis infection in a middle-aged Asian woman who initially presented with severe dyspnea on exertion and recurrent syncope, occasional burning chest pains, and fatigue. Therapy of the active hepatitis B and latent M. tuberculosis infection together with a course of methotrexate led to a slight reversal of the symptoms, as angioplasty with or without stenting was not an option. The constellation described here hints at the possible link between hepatitis B and M. tuberculosis infection and the development of Takayasu's arteritis. The case also supports the little evidence available indicating that treatment of active hepatitis B infection could positively influence the course of Takayasu's arteritis.
我们报告了一例罕见的高安动脉炎病例,该中年亚洲女性存在孤立性肺动脉狭窄,同时患有活动性乙型肝炎和潜伏性结核分枝杆菌感染,最初表现为劳力性重度呼吸困难、反复晕厥、偶尔的胸部灼痛和疲劳。对活动性乙型肝炎和潜伏性结核分枝杆菌感染进行治疗,并联合使用一个疗程的甲氨蝶呤,症状略有缓解,因为血管成形术(无论是否置入支架)均不可行。此处描述的一系列情况提示了乙型肝炎和结核分枝杆菌感染与高安动脉炎发展之间可能存在的联系。该病例也支持了现有少量证据表明的,对活动性乙型肝炎感染进行治疗可能会对高安动脉炎病程产生积极影响这一观点。