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首页> 美国卫生研究院文献>Archives of Rheumatology >Pre-Pulseless Takayasu Arteritis in a Child Represented With Prolonged Fever of Unknown Origin and Successful Management With Concomitant Mycophenolate Mofetil and Infliximab
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Pre-Pulseless Takayasu Arteritis in a Child Represented With Prolonged Fever of Unknown Origin and Successful Management With Concomitant Mycophenolate Mofetil and Infliximab

机译：在一个孩子的延长发烧的儿童中预先无毫瓦无棕榈树炎伴随着蛋白质霉素Mofetil和Flifiximab的成功管理

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Takayasu arteritis (TA) is classified as a large vessel vasculitis of predominantly aorta and its main branches, resulting in fibrosis and stenosis. Only a minority of TA patients are diagnosed in pre-stenosis phase when constitutional symptoms including fever, arthralgia, weight loss, headache, abdominal pain, and elevated acute phase reactants are dominant insidious characteristics. In this article, we present a 12-year-old female patient, who was referred to our department with a one-year history of low-grade fever, fatigue, and myalgia. Physical examination did not reveal pulse and blood pressure discrepancies between any extremities. Acute phase reactants were markedly elevated, and autoantibodies were negative. Magnetic resonance angiography (MRA) findings have confirmed TA diagnosis with prominent vessel wall thickening in the ascendant and abdominal aorta, focal ectasias and a thoracoabdominal fusiform aneurysm. As methotrexate and methylprednisolone treatment during three months was unsuccessful, infliximab was induced. During the next 12 months, patient had clinical improvement, but worsening of MRA findings and new onset of carotidynia forced us to switch methotrexate to mycophenolate mofetil. Six months later, laboratory and radiological remission were achieved. In conclusion, we report a challenge to diagnose pre-pulseless childhood-TA (c-TA) in the state of prolonged fever with no signs of vascular stenosis, systemic hypertension, pulses and blood pressure discrepancies, bruits and claudication. Therefore, we wish to discourse the importance of early diagnosis of TA since, to our knowledge, there are no studies investigating treatment success only in the early phases of c-TA.
机译：Takayasu动脉炎（TA）被归类为主要是主动脉的大容器血管炎及其主要分支，导致纤维化和狭窄。当宪法症状包括发烧，关节痛，减肥，头痛，腹痛和升高的急性期反应物时，只有少数狭窄的患者被诊断为狭窄的阶段阶段患者是显性的阴险的特征。在本文中，我们提出了一名12岁的女性患者，他们被提交给我们的部门，一年的低级发烧，疲劳和肌痛。体检没有揭示任何四肢之间的脉搏和血压差异。急性相反应物显着升高，并且自身抗体为阴性。磁共振血管造影（MRA）发现已经证实了在衰减和腹主动脉，焦平血栓壁上增厚，焦平血栓壁，焦平肌肌肌梭形梭形动脉瘤具有突出的血管壁。由于三个月内的甲氨蝶呤和甲基丙酮酮治疗不成功，诱导英夫利昔单抗。在未来12个月内，患者患有临床改善，但MRA调查结果恶化和颈蛋白的新发起迫使我们将甲氨蝶呤切换成霉酚酸酯。六个月后，实现了实验室和放射性缓解。总之，我们报告了致力于在长无紫外线儿童TA（C-TA）的挑战，延长发烧状态，没有血管狭窄，全身性高血压，脉冲和血压差异，包发和杀伤症状。因此，我们希望讨论塔的早期诊断的重要性，因为我们的知识，没有研究仅在C-TA的早期阶段调查治疗成功。

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