Acute Coronary Syndrome ; diagnosis ; drug therapy ; Female ; Humans ; Middle Aged ; Takayasu Arteritis ; diagnosis ; drug therapy

Adult ; Cyclophosphamide ; therapeutic use ; Female ; Humans ; Prednisone ; therapeutic use ; Takayasu Arteritis ; drug therapy ; surgery

Aorta ; Aortitis ; Cardiac Surgical Procedures ; Humans ; Immunosuppression ; Takayasu Arteritis/drug therapy*

Adrenal Cortex Hormones ; therapeutic use ; Adult ; Aorta, Thoracic ; pathology ; Female ; Humans ; Prednisone ; therapeutic use ; Takayasu Arteritis ; complications ; drug therapy

Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Peripheral Vascular Diseases ; drug therapy ; Phytotherapy ; Takayasu Arteritis ; drug therapy

Carbazoles ; therapeutic use ; Child, Preschool ; Heart Failure ; complications ; drug therapy ; Humans ; Male ; Propanolamines ; therapeutic use ; Takayasu Arteritis ; complications ; drug therapy ; Vasodilator Agents ; therapeutic use

BACKGROUNDTakayasu's arteritis (TA) is a chronic idiopathic inflammatory disease that affects large and medium size arteries. The brachiocephalic trunk is the most frequently involved site in TA, and multi-vessel lesions are common. Surgical treatment includes vessel reconstruction surgery and percutaneous transluminal angioplasty (PTA). Herein, we report our preliminary experience with surgical treatment of cerebral ischemia caused by cervical arterial lesions due to TA.

METHODSFrom January 2000 to December 2007, 38 patients with cerebral ischemia caused by cervical arterial occlusive lesions due to TA were treated surgically. There were three males and 35 females, with an age range of 15 - 42 years (mean 26.5 years). All patients had operative repairs undertaken. Twenty eight patients received bypass operation and 10 patients received percutaneous transluminal angioplasty. One case with coronary stenosis received coronary artery bypass simultaneously. Patients were followed up for 11 months to eight years.

RESULTSThere were no peri-operative deaths in cerebrovascular reconstruction patients. Symptoms of cerebral ischemia were improved or cured in 25 of 38 patients. There was a low incidence of cerebral reperfusion syndrome. Two patients died at five and seven years after surgery due to heart failure. Another 8 patients (20%) required further surgery for stenosis (5 patients) or anastomotic aneurysms (3 patients). Percutaneous transluminal angioplasty was performed successfully for treatment of aortic and renal lesions. Repeated angioplasty for revascularization was performed in six PTA cases with restenosis after 5 - 24 months.

CONCLUSIONSWhen cerebral perfusion has potential to be affected by TA, a definitive corrective procedure is advised when the patient is relatively stable. Although the recurrence rate is very high, percutaneous transluminal angioplasty is the first choice procedure. Bypass operation is optimal for brachiocephalic-vessel involvement in TA. Cerebral reperfusion syndrome can be avoided by careful selection of the operation method and improved post-operative treatment.

Adolescent ; Adult ; Arteritis ; drug therapy ; Brachiocephalic Trunk ; pathology ; surgery ; Brain Ischemia ; etiology ; pathology ; surgery ; Cerebral Revascularization ; methods ; Female ; Humans ; Male ; Methylprednisolone ; therapeutic use ; Takayasu Arteritis ; complications ; pathology ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the clinical features, renal histopathology and therapeutic response to glucocorticoid and immunosuppressive agents in patients with glomerular disease associated with Takayasu arteritis (TA).

METHODSPatients with TA and renal biopsy-confirmed glomerular disease were investigated retrospectively. None of them had renal artery stenosis or occlusive changes.

RESULTSSix patients with glomerulopathy, accounting for 3.75% of the 160 TA patients admitted to our hospital at the same period, were analyzed. All of them were females with a mean age of 35.5 +/- 10.0 years. Four cases presented with lower extremity edema. Laboratory tests showed that one was nephrotic syndrome, three were nephrotic range proteinuria, and two of them had mild renal dysfunction. The other two patients were asymptomatic microscopic hematuria and proteinuria. Renal pathology revealed mild immunoglobulin A nephropathy in two cases, mild mesangial proliferative glomerulonephritis (GN), membranoproliferative GN, minimal change disease, and fibrillary GN in one case respectively. Five cases received glucocorticoids and cyclophosphamide therapy. Proteinuria and microscopic hematuria disappeared in 2 to 4 weeks after the initiation of therapy in three cases. The patient with membranoproliferative GN also reached complete remission of proteinuria and recovered renal function 6 months after the treatment.

CONCLUSIONSTA may induce glomerular disease as a part of its histological spectrum. Apart from ischemic glomerular disease, glomerular disease should be suspected when TA patients have microscopic hematuria or proteinuria, that may be therapeutically responsive to glucocorticoids and immunosuppressive agent in relative early phase.

Adult ; Biopsy ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Immunosuppressive Agents ; therapeutic use ; Kidney Diseases ; drug therapy ; etiology ; pathology ; physiopathology ; Kidney Glomerulus ; pathology ; Middle Aged ; Takayasu Arteritis ; complications ; drug therapy ; pathology ; Young Adult

Takayasu arteritis (TA) is a chronic vasculitis that affects the aortic arch and its primary branches. Ulcerative colitis (UC) is an inflammatory bowel disease of unknown etiology. Patients diagnosed with both TA and UC have rarely been reported. The pathogenesis of TA and UC is uncertain, but cell-mediated mechanisms play an important role in both diseases, and a genetic factor is thought to have an effect on the coincidence of these two diseases. We herein report a 38-year-old female with TA who had a history of UC with optic neuritis. We believe that this is the first case of the coexistence of TA and UC in Korea.
Adult ; Anti-Inflammatory Agents/therapeutic use ; Aortography/methods ; Colitis, Ulcerative/*complications/diagnosis/drug therapy ; Colonoscopy ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Optic Neuritis/*complications/diagnosis/drug therapy ; Positron-Emission Tomography ; Republic of Korea ; Steroids/therapeutic use ; Takayasu Arteritis/*complications/diagnosis/drug therapy ; Tomography, X-Ray Computed ; Treatment Outcome

No abstract available.
Aged ; Antibodies, Antiphospholipid/blood ; Anticoagulants/therapeutic use ; Antiphospholipid Syndrome/blood/*complications/diagnosis/drug therapy ; Biomarkers/blood ; Female ; Fluorodeoxyglucose F18 ; Glucocorticoids/therapeutic use ; Humans ; Multimodal Imaging/methods ; Positron-Emission Tomography ; Radiopharmaceuticals ; Takayasu Arteritis/*complications/diagnosis/drug therapy ; Tomography, X-Ray Computed ; Treatment Outcome