Zhang Fang, Dong Bingzi, Yang Libo, Liu Jiaxin, Zhan Jinfeng, Cui Yukun, Lin Hua, Wang Yangang, Lv Wenshan
Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Department of Endocrinology, Tai'an Central Hospital Affiliated to Qingdao University, Tai'an, Shandong, China.
Front Pediatr. 2024 Aug 16;12:1432362. doi: 10.3389/fped.2024.1432362. eCollection 2024.
Takayasu's arteritis is a primary systemic vasculitis that affects predominantly large vessels, affecting the aorta and its major branches. We report a case of adolescent female patient who initially experienced numbness and weakness in her limbs, subsequently developing severe hypertension. Physical examination revealed uneven blood pressure in the limbs and a murmur in the auscultation area of the abdominal aorta without decreased pulses. Auxiliary examinations revealed diffuse blood vessel stenosis, leading to the diagnosis of Takayasu's arteritis. One month later, the patient was diagnosed with multiple cerebral hemorrhages following sudden impairment of limb movement. Digital subtraction angiography did not reveal any evident vascular malformations or aneurysms. Following surgery and biologic intervention with tocilizumab, the patient's condition improved, with no new bleeding episodes and stable blood pressure control achieved. We also reviewed the literature that have been previously reported with hypertensive intracerebral hemorrhage complicated by Takayasu's arteritis. We recommend that Takayasu's arteritis be taken into account when considering the hypertension in young patients. Timely vascular imaging and standardized treatment are imperative for diagnosing and managing effectively.
高安动脉炎是一种主要累及大血管的原发性系统性血管炎，主要影响主动脉及其主要分支。我们报告一例青春期女性患者，该患者最初出现肢体麻木和无力，随后发展为严重高血压。体格检查发现四肢血压不均，腹主动脉听诊区有杂音，脉搏未减弱。辅助检查显示弥漫性血管狭窄，导致诊断为高安动脉炎。一个月后，患者在肢体运动突然受损后被诊断为多发性脑出血。数字减影血管造影未发现任何明显的血管畸形或动脉瘤。经过手术和使用托珠单抗的生物干预后，患者病情好转，未出现新的出血事件，血压控制稳定。我们还回顾了先前报道的高安动脉炎并发高血压性脑出血的文献。我们建议在考虑年轻患者的高血压时应考虑高安动脉炎。及时进行血管成像和标准化治疗对于有效诊断和管理至关重要。
