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一例表现为单纯严重主动脉瓣关闭不全的Takayasu动脉炎罕见病例:病例报告

An unusual case of Takayasu arteritis presenting as isolated severe aortic regurgitation: A case report.

作者信息

Simkhada Ankita, Acharya Pritha, Tiwari Sansar Babu, K C Bibek

机构信息

Department of Pathology, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Bagmati Province, Nepal.

Department of Pathology, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Bagmati Province, Nepal.

出版信息

Int J Surg Case Rep. 2023 Jul;108:108407. doi: 10.1016/j.ijscr.2023.108407. Epub 2023 Jun 15.

Abstract

INTRODUCTION

Takayasu arteritis is a chronic granulomatous vasculitis involving the large vessels, mainly the aorta and its branches.

CASE PRESENTATION

We report a case of a young female who presented with severe shortness of breath and easy fatigability. Examination revealed a diastolic murmur and imaging studies revealed a severe aortic regurgitation with aneurysm of the aortic root and ascending aorta.

CLINICAL DISCUSSION

Modified Bentall's procedure was performed and sample sent for histopathology which showed granulomatous inflammation of the aorta with elastic fibre destruction in the medial layer. Infective causes of aortic aneurysm were ruled out and a diagnosis of Takayasu arteritis was made on the basis of clinical, radiological and histological findings.

CONCLUSION

This case highlights the unusual presentation of Takayasu arteritis in which the patient had severe aortic regurgitation and aneurysm of the ascending aorta without steno-occlusive lesion elsewhere.

摘要

引言

高安动脉炎是一种累及大血管的慢性肉芽肿性血管炎,主要累及主动脉及其分支。

病例报告

我们报告一例年轻女性患者,她出现严重气短和易疲劳症状。检查发现舒张期杂音,影像学检查显示严重主动脉瓣关闭不全,伴有主动脉根部和升主动脉瘤。

临床讨论

实施了改良Bentall手术,并将样本送去做组织病理学检查,结果显示主动脉肉芽肿性炎症,中层弹性纤维破坏。排除了主动脉瘤的感染性病因,根据临床、放射学和组织学检查结果诊断为高安动脉炎。

结论

该病例突出了高安动脉炎的不寻常表现,即患者有严重主动脉瓣关闭不全和升主动脉瘤,而其他部位无狭窄闭塞性病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fd3/10382717/0d89b100ddfa/gr1.jpg

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