Arteritis de Takayasu: Revisión de criterios diagnósticos y terapéuticos a propósito de un caso clínico

Carlos Dufrechou; Santiago Cedrés; Rosanna Robaina; Juan Carlos Bagattini

Authors

Carlos Dufrechou Universidad de la República, Facultad de Medicina, Hospital Pasteur, Clínica Médica "2", Prof. Agregado
Santiago Cedrés Universidad de la República, Facultad de Medicina, Hospital Pasteur, Clínica Médica "2", Asistente de Clínica
Rosanna Robaina Universidad de la República, Facultad de Medicina, Hospital Pasteur, Clínica Médica "2", Prof. Adjunto
Juan Carlos Bagattini Universidad de la República, Facultad de Medicina, Hospital Pasteur, Clínica Médica "2", Prof. Clínica Médica

Keywords:

TAKAYASU ARTERITIS

Abstract

A case report of a woman carrier of Takayasu arteritis with coronary injuries is presented. The patient reached five out of six criteria of the American College of Rheumatology and five out of seven diagnostic criteria of Ishikawa.The woman was admitted to the hospital because of coronary symptoms with unstable angor of high risk. She underwent cineangiocoronarygraphy that showed significant coronary injuries; two stents were implanted in the affected arteries.The association between injuries and atherosclerotic degenerative disease was analyzed due to the profusion of vascular risk factors seen in the patient: diabetes, hypertension, dyslipidemia and smoking.
Clinical history is adjusted to a predominance of inflammatory over degenerative injuries since we considered a coexistence of both diseases.
Post corticosteroid treatment follows up coincided with our findings: dramatic improvement in general conditions, decrease of erythrocyte sedimentation rates, and anemia improvement.
Vascular injuries improvement was not demonstrated, there was no significant difference between prior and post steroid treatment aortography. This is congruent with international experience since injuries have a scared fibrous component, without improvement under antimflammatory treatment.

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