Clinical features and prognosis of children with multiple Takayasu′s arteritis complicated with carotid artery occlusion
10.3760/cma.j.cn112150-20240602-00444
- VernacularTitle:多发性大动脉炎合并颈动脉闭塞儿童的临床特征及预后分析
- Author:
Baoping HE
1
;
Jianming LAI
Author Information
1. 内蒙古医科大学附属医院，呼和浩特 010010
- Publication Type:Journal Article
- Keywords:
Children;
Takayasu′s arteritis;
Arteria carotis communis;
Occlusion
- From:
Chinese Journal of Preventive Medicine
2024;58(12):2033-2037
- CountryChina
- Language:Chinese
-
Abstract:
This study aimed to analyze the clinical characteristics and prognosis of Takayasu′s arteritis (TA) with carotid artery occlusion in children. This study collected clinical data and follow-up information on the first diagnosis and treatment of c-TA combined with carotid artery occlusion in pediatric patients at the Children′s Hospital affiliated with the Capital Institute of Pediatrics and Inner Mongolia Medical University Affiliated Hospital from 2013 to 2023. This study included four female patients with a mean age of (13.25±1.71) years old. The time from onset to diagnosis was (8.14±11.19) months. Their main clinical symptoms and signs were dizziness, headache, chest discomfort, aphasia, dyskinesia, impaired mobility of the limbs, hypertension, asymmetry of blood pressure in the limbs, vascular murmurs or tremors, weakened radial artery pulsation, and decreased muscle strength. All four children showed elevated levels of C-reactive protein and erythrocyte sedimentation rate. The medical imaging results showed that among the four patients, three had bilateral carotid artery occlusion, and one had unilateral carotid artery occlusion. There were three cases of cerebrovascular involvement, accompanied by arterial involvement in multiple parts of the body, mainly involving bilateral subclavian arteries, cephalic trunk arteries, bilateral renal arteries, bilateral iliac arteries, and middle cerebral arteries. Four children were effectively treated with glucocorticoids and immunosuppressants. These children were followed up for a period of (42.25±52.54) months, which showed that the original affected artery still had varying degrees of occlusion, with no progression from the pre-treatment period and no new arterial involvement. The condition of three children with pre-existing physical and language disorders gradually improved. In summary, children with c-TA combined with carotid artery occlusion can cause involvement of multiple blood vessels. Their clinical manifestations are mostly systemic symptoms and ischemia of corresponding supply organs caused by vascular lesions, which are prone to be combined with cerebral infarction, and their occluded blood vessels are difficult to recover.
