Aggressive progression of Takayasu’s arteritis in infancy: a case report

SUMMARY Takayasu’s arteritis (TA) affects the aorta and its branches. Immunosuppressants are the usual course of therapy, while surgery has been used in acute cases. There is only scant information on TA in infancy, and the nonspecific symptoms in the initial stage of the disease make the diagnosis difficult and delayed, thus increasing the mortality rate. We describe a case of aggressive progression of TA in an infant. This child was the youngest to be affected with the disease as reported in the literature. A 3.5-month-old boy presented with cyanosis of both legs, tachycardia and antithrombin III deficiency. Computed tomography angiography (CTA) revealed thrombosis of distal aorta and both iliac arteries. Thrombectomy was performed at the level of both common femoral arteries. In addition, thigh amputation of the left leg had to be performed. TA was diagnosed postmortem with thrombosis of the distal aorta, its branches and upper mesenteric artery which was not occluded on previous CTA, glomerulonephritis and pulmonary parenchymal granulomatous infiltrations.

[1]  I. Malcic,et al.  [TAKAYASU ARTERITIS AND POSSIBLE CARDIOLOGY REPERCUSSIONS IN THE CHILDHOOD]. , 2015, Reumatizam.

[2]  M. Terreri,et al.  Developments in large and midsize vasculitis. , 2013, Rheumatic diseases clinics of North America.

[3]  M. Hosseini,et al.  Acute necrotizing large vessel arteritis in a newborn: a case report and review of the literature. , 2013, The American journal of forensic medicine and pathology.

[4]  S. Ozen,et al.  Takayasu arteritis in a 4-year-old girl: case report and brief overview of the pediatric literature. , 2012, The Turkish journal of pediatrics.

[5]  A. Bagga,et al.  Large vessel vasculitis , 2009, Pediatric Nephrology.

[6]  G. Zilleruelo,et al.  Renal manifestations in toddlers with Takayasu’s arteritis and malignant hypertension , 2009, Pediatric Nephrology.

[7]  S. Ozen,et al.  Takayasu arteritis in children. , 2008, The Journal of rheumatology.

[8]  K. Sano [Takayasu disease--pulseless disease]. , 2008, Brain and nerve = Shinkei kenkyu no shinpo.

[9]  K. Maksimowicz-McKinnon,et al.  Limitations of therapy and a guarded prognosis in an American cohort of Takayasu arteritis patients. , 2007, Arthritis and rheumatism.

[10]  A. Anarat,et al.  Childhood vasculitides in Turkey: a nationwide survey , 2006, Clinical Rheumatology.

[11]  C. Nordborg,et al.  Large vessel vasculitis - giant cell arteritis. , 2004 .

[12]  S. Andronikou,et al.  Angiographic features of 26 children with Takayasu's arteritis , 2003, Pediatric Radiology.

[13]  M. Kiss,et al.  [Takayasu's arteritis]. , 2003, Anales de pediatria.

[14]  C. Sandborg,et al.  Magnetic resonance imaging in the diagnosis and follow up of Takayasu's arteritis in children , 2002, Annals of the rheumatic diseases.

[15]  R. Tulloh,et al.  Takayasu disease masquarading as interruption of the aortic arch in a 2-year-old child , 2001, Cardiology in the Young.

[16]  S. Jain,et al.  Takayasu arteritis in children and young indians. , 2000, International journal of cardiology.

[17]  S. Bavdekar,et al.  Study of Takayasu's arteritis in children: clinical profile and management. , 2000, Journal of postgraduate medicine.

[18]  N. Mohan,et al.  Takayasu’s arteritis , 1999, Current treatment options in cardiovascular medicine.

[19]  S. E. Levin,et al.  A review of Takayasu’s arteritis in children in Gauteng, South Africa , 1998, Pediatric Nephrology.

[20]  E. Czeizel,et al.  [Genetic counseling in a case of Takayasu arteritis]. , 1996, Orvosi hetilap.

[21]  Guy Hoffman,et al.  Takayasu Arteritis , 1994, Annals of Internal Medicine.

[22]  C. Pineda,et al.  Takayasu's arteritis in children. , 1991, The Journal of rheumatology.

[23]  P. Huttenlocher,et al.  Takayasu arteritis: a treatable cause of stroke in infancy. , 1986, Pediatric neurology.

[24]  J. Balfe,et al.  Three patients with arteritis. , 1984, Archives of disease in childhood.

[25]  L. Es,et al.  Acquired antithrombin III deficiency and thrombosis in the nephrotic syndrome. , 1978, The American journal of medicine.