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高安动脉炎合并肠系膜上动脉狭窄和双侧肾动脉炎:一例临床病例报告

Takayasu Arteritis Complicated by Superior Mesenteric Artery Stenosis and Bilateral Renal Arteritis: A Clinical Case Report.

作者信息

Oruganti Mallikarjuna S, Haroon Ahmed Mohammed, Nadeem Ayman, Narreddy Manasi, Simarla Sumana, Manideep Katta, Athmakuri Krishna S, Sheik Asma Farheen, Bairam Saieesh, Tabassum Sameena

机构信息

Internal Medicine, Osmania Medical College, Hyderabad, IND.

Radiodiagnosis, Gandhi Medical College, Hyderabad, IND.

出版信息

Cureus. 2024 Oct 27;16(10):e72477. doi: 10.7759/cureus.72477. eCollection 2024 Oct.

Abstract

Takayasu arteritis (TA), a rare large-vessel vasculitis, primarily affects women of childbearing age, causing granulomatous inflammation in the aorta and its major branches. This inflammation can lead to stenosis, aneurysms, or occlusion, with the abdominal aorta, subclavian, and brachial arteries commonly involved. We present the case of a 26-year-old female with TA with a rare involvement of the superior mesenteric artery (SMA). The patient presented with progressive shortness of breath and exertional pain in the left upper limb, suggesting claudication. Echocardiography showed an ejection fraction of 45% and right ventricular systolic pressure of 65 mmHg. CT angiography (CTA) revealed diffuse involvement of the abdominal aorta with non-opacification of SMA, and other findings were consistent with TA type 5. The patient was successfully treated with methylprednisolone to induce remission, along with guideline-directed medical therapy for heart failure.

摘要

高安动脉炎(TA)是一种罕见的大血管血管炎,主要影响育龄女性,可导致主动脉及其主要分支出现肉芽肿性炎症。这种炎症可导致狭窄、动脉瘤或闭塞,腹主动脉、锁骨下动脉和肱动脉常受累。我们报告一例26岁患有TA的女性病例,其肠系膜上动脉(SMA)罕见受累。患者表现为进行性气短和左上肢运动性疼痛,提示间歇性跛行。超声心动图显示射血分数为45%,右心室收缩压为65 mmHg。CT血管造影(CTA)显示腹主动脉弥漫性受累,SMA不显影,其他表现符合5型TA。患者通过甲基强的松龙诱导缓解,并接受心力衰竭的指南指导药物治疗,治疗成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40f/11590758/81ff6f676e26/cureus-0016-00000072477-i01.jpg

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