Undetected Takayasu arteritis presenting as severe hypertension in children: a report of two cases
Abstract
Takayasu arteritis (TA) is a rare chronic granulomatous vasculitis mainly affecting the aorta and its main branches. Clinical presentations of TA are non-specific, especially in the initial phase, which likely contributes to delayed diagnosis besides the rarity of the disorder. Childhood-onset of TA is associated with significant morbidity and mortality. This case report aimed to present two rare cases of acute symptomatic severe hypertension in children due to TA.
References
Kothari S. Takayasu’s arteritis in children - a review. Images Paediatr Cardiol. 2001 ;3:4–23. PMID: 22368604.
Aeschlimann FA, Twilt M, Yeung RSM. Childhood-onset Takayasu Arteritis. Eur J Rheumatol. 2020;7:S58–66. DOI: https://doi.org/10.5152/eurjrheum.2019.19195
Brunner J, Feldman BM, Tyrrell PN, Kuemmerle-Deschner JB, Zimmerhackl LB, Gassner I, et al. Takayasu arteritis in children and adolescents. Rheumatology (Oxford). 2010;49:1806–14. DOI: https://doi.org/10.1093/rheumatology/keq167
Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al. EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis. 2010;69:798–806. DOI: https://doi.org/10.1136/ard.2009.116657
Li Cavoli G, Mulè G, Vallone MG, Caputo F. Takayasu’s disease effects on the kidneys: Current perspectives. Int J Nephrol Renovasc Dis. 2018;11:225–33. DOI: https://doi.org/10.2147/IJNRD.S146355
Ying S, Sifan W, Yujiao W, Rongyi C, Qingrong H, Lili M, et al. Clinical characteristics, imaging phenotypes and events free survival in Takayasu arteritis patients with hypertension. Arthritis Res Ther. 2021;23:196. DOI: https://doi.org/10.1186/s13075-021-02579-8
Sadurska E, Jawniak R, Majewski M, Czekajska-Chehab E. Takayasu arteritis as a cause of arterial hypertension. Case report and literature review. Eur J Pediatr. 2012;171:863–9. DOI: https://doi.org/10.1007/s00431-012-1674-z
Sun Y, Dai X, Lv P, Dong Z, Ma L, Yan Y, et al. Characteristics and medium-term outcomes of Takayasu arteritis-related Renal artery stenosis: Analysis of a large Chinese cohort. J Rheumatol. 2021;48:87–93. DOI: https://doi.org/10.3899/jrheum.190965
Mathew AJ, Goel R, Kumar S, Danda D. Childhood-onset Takayasu arteritis: an update. Int J Rheum Dis. 2016;19:116–26. DOI: https://doi.org/10.1111/1756-185X.12718
Sreih AG, Cronin K, Shaw DG, Young K, Burroughs C, Kullman J, et al. Diagnostic delays in vasculitis and factors associated with time to diagnosis. Orphanet J Rare Dis. 2021;16:184. DOI: https://doi.org/10.1186/s13023-021-01794-5
Kötter I, Henes JC, Wagner AD, Loock J, Gross WL. Does glucocorticosteroid-resistant large-vessel vasculitis (giant cell arteritis and Takayasu arteritis) exist and how can remission be achieved? A critical review of the literature. Clin Exp Rheumatol. 2012;30:S114-29.
Jeong HS, Jung JH, Song GG, Choi SJ, Hong SJ. Endovascular balloon angioplasty versus stenting in patients with Takayasu arteritis: A meta-analysis. Medicine (Baltimore). 2017;96:e7558. DOI: https://doi.org/10.1097/MD.0000000000007558
Casalini E, Sfondrini MS, Fossali E. Two-year clinical follow-up of children and adolescents after percutaneous transluminal angioplasty for renovascular hypertension. Invest Radiol. 1995;30:40–3. DOI: https://doi.org/10.1097/00004424-199501000-00006
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Accepted 2024-10-08
Published 2024-10-21