Maita Hiroki, Kobayashi Tadashi, Akimoto Takashi, Ota Shinji, Sakuraba Hirotake, Kato Hiroyuki
Development of Community Healthcare, Hirosaki University Graduate School of Medicine, Aomori, Japan.
Department of General Medicine, Hirosaki University School of Medicine and Hospital, Aomori, Japan.
SAGE Open Med Case Rep. 2023 Jul 31;11:2050313X231190493. doi: 10.1177/2050313X231190493. eCollection 2023.
A 51-year-old otherwise healthy woman was referred to our hospital with a fever of unknown origin, liver dysfunction, and anemia. One month prior, she had persistent and spontaneous anterior neck pain, with no exacerbation during swallowing or neck movements. Physical examination revealed no pharyngeal or tonsillar abnormalities, heart murmur, arthritis, skin rash, or lymphadenopathy, except for mild bilateral common carotid artery tenderness at the level of the thyroid cartilage. Blood tests showed nonspecific chronic inflammatory findings, anemia, and liver damage, whereas blood cultures, viral antibodies, interferon-γ release assay, and antibodies specific for any collagen disease showed negative results. Echocardiography and computed tomography without contrast of the neck, chest, abdomen, and pelvis showed no apparent abnormalities. She was subsequently diagnosed with Takayasu arteritis using positron emission tomography. Identifying a characteristic history of bilateral carotid artery tenderness and subsequent positron emission tomography can be useful for diagnosing Takayasu arteritis.
一名51岁的健康女性因不明原因发热、肝功能不全和贫血被转诊至我院。1个月前，她持续出现自发性颈部前方疼痛，吞咽或颈部活动时无加重。体格检查未发现咽部或扁桃体异常、心脏杂音、关节炎、皮疹或淋巴结病，仅在甲状腺软骨水平有轻度双侧颈总动脉压痛。血液检查显示非特异性慢性炎症表现、贫血和肝损伤，而血培养、病毒抗体、干扰素-γ释放试验以及针对任何胶原病的抗体检查结果均为阴性。颈部、胸部、腹部和骨盆的超声心动图及非增强计算机断层扫描未显示明显异常。随后通过正电子发射断层扫描诊断为大动脉炎。识别双侧颈动脉压痛的特征性病史及随后的正电子发射断层扫描对大动脉炎的诊断可能有用。
