Faculty of Medicine, 61786Lucian Blaga University of Sibiu, Lucian Blaga University of Sibiu, Sibiu, Romania.
Infectious Diseases Clinic, Academic Emergency Hospital, Sibiu, Romania.
J Int Med Res. 2021 Nov;49(11):3000605211055388. doi: 10.1177/03000605211055388.
Takayasu's arteritis is a rare, systemic, inflammatory vasculitis of large blood vessels with an unknown aetiology that more frequently affects women of childbearing age with progression to stenosis, fibrosis or thrombogenesis. Clinical manifestations are associated either with inflammation of the vascular wall (including fever, myalgia, arthralgia, weight loss) or the development of aneurysms and extensive vascular lesions, which creates challenges for a differential diagnosis. This current report presents the case of a female Caucasian patient, aged 23 years, that presented herself repetitively at the hospital reporting symptoms including fever, productive cough, myalgia associated with physical effort, arthralgia, inconstant headache, weight loss and altered general condition. The patient was diagnosed with Takayasu's arteritis in the context of a prolonged febrile syndrome associated with reactive thrombocytosis. This association results in the need to exclude multiple differential diagnoses. Nonspecific management was initiated, which included antibiotic treatment, antifungal medication, anticoagulants, steroidal anti-inflammatory drugs and correction of anaemia. The patient slowly improved. Takayasu's arteritis in the inflammatory phase associated with a prolonged febrile syndrome and reactive thrombocytosis is a rare diagnosis of exclusion of a multitude of inflammatory diseases of large blood vessels, infectious diseases and neurofibromatosis, which requires multiple investigations for an accurate diagnosis and management.
Takayasu 动脉炎是一种罕见的、系统性的、大血管炎症性血管炎，病因不明，更常影响育龄妇女，可进展为狭窄、纤维化或血栓形成。临床表现与血管壁炎症（包括发热、肌痛、关节炎、体重减轻）或动脉瘤和广泛血管病变的发展有关，这给鉴别诊断带来了挑战。本报告介绍了一位 23 岁的白人女性患者的病例，她反复到医院就诊，报告的症状包括发热、咳嗽、与体力活动相关的肌痛、关节炎、不定时头痛、体重减轻和一般状况改变。该患者被诊断为 Takayasu 动脉炎，伴有长期发热综合征和反应性血小板增多症。这种关联导致需要排除多种鉴别诊断。开始进行非特异性治疗，包括抗生素治疗、抗真菌药物、抗凝药物、类固醇抗炎药物和纠正贫血。患者逐渐好转。Takayasu 动脉炎在炎症期伴有长期发热综合征和反应性血小板增多症，是一种排除多种大血管炎症性疾病、传染病和神经纤维瘤病的罕见诊断，需要进行多项检查以做出准确诊断和治疗。
