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GIRL WITH TAKAYASU ARTERITIS -PROGRESSIVE COURSE OF THE DISEASE AND MULTIPLE SURGICAL INTERVENTIONS
IVAN MALČIĆ
; Klinički bolnički centar Zagreb, Zavod za pedijatrijsku kardiologiju, Zagreb, Hrvatska
AGNEZA MARIJA PASINI
; Klinika za dječje bolesti Zagreb, Odjel za pulmologiju, alergologiju, imunologiju i reumatologiju, Zagreb, Hrvatska
MAJA HRABAK PAAR
; Klinički bolnički centar Zagreb, Zavod za dijagnostičku i intervencijsku radiologiju, Zagreb, Hrvatska
HANNES MUELLER
; Sveučilišne Klinike Kepler, Klinika za kardiokirurgiju, torakalnu kirurgiju i vaskularnu kirurgiju, Linz Med Kampus III., Linz, Austrija
RUDOLF MAIR
; Sveučilišne Klinike Kepler, Klinika za kardiokirurgiju, torakalnu kirurgiju i vaskularnu kirurgiju, Linz Med Kampus III., Linz, Austrija
DRAŽEN PERKOV
; Klinički bolnički centar Zagreb, Zavod za dijagnostičku i intervencijsku radiologiju, Zagreb, Hrvatska
KRISTINA MARIĆ
; Klinički bolnički centar Zagreb, Zavod za kardiovaskularnu medicinu, Zagreb, Hrvatska
MARIJA JELUŠIĆ
; Department of Pediatric Rheumatology and Immunology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Hrvatska
Sažetak
Takayasu arteritis is a rare large-vessel vasculitis but it can be associated with high mortality rates in childhood. Granulomatous vasculitis usually affects the aorta and/or main branches but also coronary and pulmonary arteries. The course of the disease is unpredictable and management is based on controlling infl ammation and preventing end-organ damage. In this case we describe a patient with progression of vasculitis but so far successful prevention of possible ischemic consequences using immunosupressive and biologic therapy and multiple surgical interventions over the course of the disease. A 14-year-old girl presented with precordial pain and numbness of the left arm. Physical examination revealed the absence of the radial pulse in the left arm. Computed tomography angiography showed subtotal occlusion of the left main coronary artery, subtotal occlusionof the left common carotid artery, subtotal occlusion of the left subclavian artery and stenosis of thoracic aorta below isthmus of aortae. Despite aggresive conservative therapy and cardiosurgical treatment the course of the disease was complicated with restenoses which were resolved with subsequent revascularization procedures. Here we present an adolescent girl with progressive vasculitis and with multiple surgical interventions. Carefully monitoring of the patient and good collaboration between pediatric cardiologist and rheumatologist with radiologists and cardiac surgeons improved life-quality of the patient which now studies at the University and has good physical and mental status.
Ključne riječi
childhood Takayasu arteritis; progressive course; surgical interventions; revascularization
Hrčak ID:
244549
URI
Datum izdavanja:
6.10.2020.
Posjeta: 990 *