Takayasu Arteritis as a Secondary Cause of Arterial Hypertension

Abstract Takayasu arteritis (TA) is a rare type of vasculitis that affects mainly the aorta and its major branches. It is highly similar to giant cell arteritis (GCA), and differentiation between them may not be achieved even by histological examination. Arterial hypertension is typical of TA and is caused by stenosis of the renal arteries. Here we report the case of a 59-year-old woman, with a history of dyslipidemia and anemia, seen in the Internal Medicine department for resistant hypertension. Evaluation of secondary causes led to stenosis of the renal arteries. Assessment of target organ involvement was performed by computed tomography angiograph which revealed ectasia of the aortic arch and ascending aorta, tortuous course of the brachiocephalic trunk and the proximal portion of the right common carotid artery; positron-emission tomography which showed diffuse increased uptake in the ascending aorta, compatible with large vessels vasculitis. The patient was submitted to aortic valve replacement with a biological prosthesis combined with myocardial revascularization (Bentall-De Bono procedure). Aortic biopsy specimens showed anatomical and pathological features of GCA and TA. Due to persistently uncontrolled hypertension, prednisone 60 mg was initiated,with significant improvement in patient’s condition.

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Main Authors: Oliveira,Pedro Manuel, Fereira,Paula, Murteira,Fábio, Rato,Inês Rueff, Barbedo,Marta
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Cardiologia 2023
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472023000100502
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spelling oai:scielo:S2359-564720230001005022023-01-24Takayasu Arteritis as a Secondary Cause of Arterial HypertensionOliveira,Pedro ManuelFereira,PaulaMurteira,FábioRato,Inês RueffBarbedo,Marta Takayasu Arteritis Hypertension Renal Artery Obstruction Aorta, Thoracic Computed Tomography Angiography/ methods Abstract Takayasu arteritis (TA) is a rare type of vasculitis that affects mainly the aorta and its major branches. It is highly similar to giant cell arteritis (GCA), and differentiation between them may not be achieved even by histological examination. Arterial hypertension is typical of TA and is caused by stenosis of the renal arteries. Here we report the case of a 59-year-old woman, with a history of dyslipidemia and anemia, seen in the Internal Medicine department for resistant hypertension. Evaluation of secondary causes led to stenosis of the renal arteries. Assessment of target organ involvement was performed by computed tomography angiograph which revealed ectasia of the aortic arch and ascending aorta, tortuous course of the brachiocephalic trunk and the proximal portion of the right common carotid artery; positron-emission tomography which showed diffuse increased uptake in the ascending aorta, compatible with large vessels vasculitis. The patient was submitted to aortic valve replacement with a biological prosthesis combined with myocardial revascularization (Bentall-De Bono procedure). Aortic biopsy specimens showed anatomical and pathological features of GCA and TA. Due to persistently uncontrolled hypertension, prednisone 60 mg was initiated,with significant improvement in patient’s condition.info:eu-repo/semantics/openAccessSociedade Brasileira de CardiologiaInternational Journal of Cardiovascular Sciences v.36 20232023-01-01info:eu-repo/semantics/reporttext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472023000100502en10.36660/ijcs.20210040
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countrycode BR
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databasecode rev-scielo-br
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libraryname SciELO
language English
format Digital
author Oliveira,Pedro Manuel
Fereira,Paula
Murteira,Fábio
Rato,Inês Rueff
Barbedo,Marta
spellingShingle Oliveira,Pedro Manuel
Fereira,Paula
Murteira,Fábio
Rato,Inês Rueff
Barbedo,Marta
Takayasu Arteritis as a Secondary Cause of Arterial Hypertension
author_facet Oliveira,Pedro Manuel
Fereira,Paula
Murteira,Fábio
Rato,Inês Rueff
Barbedo,Marta
author_sort Oliveira,Pedro Manuel
title Takayasu Arteritis as a Secondary Cause of Arterial Hypertension
title_short Takayasu Arteritis as a Secondary Cause of Arterial Hypertension
title_full Takayasu Arteritis as a Secondary Cause of Arterial Hypertension
title_fullStr Takayasu Arteritis as a Secondary Cause of Arterial Hypertension
title_full_unstemmed Takayasu Arteritis as a Secondary Cause of Arterial Hypertension
title_sort takayasu arteritis as a secondary cause of arterial hypertension
description Abstract Takayasu arteritis (TA) is a rare type of vasculitis that affects mainly the aorta and its major branches. It is highly similar to giant cell arteritis (GCA), and differentiation between them may not be achieved even by histological examination. Arterial hypertension is typical of TA and is caused by stenosis of the renal arteries. Here we report the case of a 59-year-old woman, with a history of dyslipidemia and anemia, seen in the Internal Medicine department for resistant hypertension. Evaluation of secondary causes led to stenosis of the renal arteries. Assessment of target organ involvement was performed by computed tomography angiograph which revealed ectasia of the aortic arch and ascending aorta, tortuous course of the brachiocephalic trunk and the proximal portion of the right common carotid artery; positron-emission tomography which showed diffuse increased uptake in the ascending aorta, compatible with large vessels vasculitis. The patient was submitted to aortic valve replacement with a biological prosthesis combined with myocardial revascularization (Bentall-De Bono procedure). Aortic biopsy specimens showed anatomical and pathological features of GCA and TA. Due to persistently uncontrolled hypertension, prednisone 60 mg was initiated,with significant improvement in patient’s condition.
publisher Sociedade Brasileira de Cardiologia
publishDate 2023
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472023000100502
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