Professional paper

TAKAYASU ARTERITIS AND POSSIBLE CARDIOLOGY REPERCUSSIONS IN THE CHILDHOOD

Ivan Malčić
Petra Detoni
Hrvoje Kniewald
Dorotea Bartoniček
Daniel Dilber
Dubravka Dietrich
Marija Jelušić

Abstract

Vasculitides are rare rheumatic diseases of unknown etiology
whose main characteristic is a necrotizing infl ammation
of blood vessels. We are presenting two patients
with Takayasu arteritis (TA) as entity forms of rare rheumatic
diseases. One patient had TA type IIa and the other
type IV. In the fi rst patient we found severe symptoms of
obstructive lesions of aortic branches, particularly severe
coronary artery stenosis and complete occlusion of the left
subclavian artery, and thoracic artery stenosis below the
isthmus. Th e disease was diagnosed in the acute phase,
treated extensively with medicaments (glucocorticoids,
cytostatics, methotrexate) and a complex cardiac surgical
procedure, and due to relapse the biological (Rituximab)
therapy was used. Th e second patient was detected
following symptomatic arterial hypertension, with absent pulses of lower limbs, whose cause was found in severe
narrowing of the aorta from diaphragm to femoral arteries
bifurcation (mid-aortic syndrome). Th e disease was
not active when diagnosis was made. Th e patient was treated
with a particular cardiac surgical procedure and with
multiple medicaments due to a relapse. Both patients have
reached adolescent age and are successfully treated with a
satisfying quality of life. Type IIa with an additional occlusion
of coronary arteries is not described in the available
literature. Forementioned vasculitides emphasize the
importance of pediatric cardiologists and rheumatologists
teamwork.

Keywords

vasculitis; Takayasu arteritis; child; cardiac surgery; biological therapy

Hrčak ID:

182722

URI

https://hrcak.srce.hr/182722

Publication date:

9.11.2015.

Article data in other languages: croatian

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