The analysis of the clinical records diagnosed as Takayasu’s arteritis with pulmonary vascular involvement_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

XIAO Yao ¹ ,  YANG Jinghua ¹ , HUANG Xiaoyong ² , ZHANG Ying ¹ , WU Chunting ¹

1. Department of Respiratory and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;
2. Department of Invasive Technology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;

Corresponding?author：

YANG Jinghua, Email: yjh651216@163.com

Keywords：

Takayasu’s arteritis; Pulmonary arterial hypertension; Clinical features

DOI：

10.7507/1671-6205.201803040

Video：

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ObjectiveTo enhance the understanding of Takayasu’s arteritis (TA) with pulmonary vascular involvement through the analyses on clinical features.MethodsA retrospective study was conducted to analyze the clinical records of patients diagnosed as TA with pulmonary vascular involvement admitted to Beijing Anzhen Hospital from January 2007 to August 2017.ResultsIn recent 10 years, there were 233 patients diagnosed as TA in Beijing Anzhen Hospital, 17 of them were involved with pulmonary arterial, which accounted for 7.3%. Fourteen patients were females, 3 patients were males. The age ranged from 16 to 59 years with an average of (40±13) years. Among the 17 patients, dyspnea (15 cases, 88.2%) was the most common symptom, and unequal blood pressure of upper limbs (9 cases, 52.9%) was the main sign. Thirteen patients had pulmonary hypertension by echocardiographic examination. Angiographic data showed that multi-lobular and multi-segmental pulmonary branches were predominantly affected. Unilateral involvement of pulmonary artery was more common than bilateral involvement, while the right pulmonary arteries were more often affected than the left. Thirteen patients received hormone and immunosuppressive therapy, 11 patients received anticoagulation or antiplatelet therapy, and 5 patients received targeted treatment of pulmonary artery pressure.ConclusionsThe clinical manifestation of TA is unspecific and misdiagnosis rate is relatively high. Improving the understanding of TA is necessary so as to reduce the misdiagnosis rate at an early stage and ameliorate the prognosis.

Citation： XIAO Yao, YANG Jinghua, HUANG Xiaoyong, ZHANG Ying, WU Chunting. The analysis of the clinical records diagnosed as Takayasu’s arteritis with pulmonary vascular involvement. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(4): 364-368. doi: 10.7507/1671-6205.201803040 Copy

1.	Zheng DY, Liu LS, Fan DJ. Clinical studies in 500 patients with aortoarteritis. Chin Med J (Engl), 1990, 103(7): 536-540.
2.	Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum, 1990, 33(8): 1129-1134.
3.	姜維, 呂秀章, 楊媛華, 等. 超聲心動圖評價大動脈炎肺動脈受累患者右心功能的臨床研究. 中國超聲醫學雜志, 2016, 32(6): 517-519.
4.	楊明, 曾勇, 沈珠軍, 等. 大動脈炎累及冠狀動脈的臨床特點及介入治療效果分析. 中華醫學雜志, 2014, 94(24): 1874-1877.
5.	孫菲, 梅慧敏, 田新平, 等. 大動脈炎心臟瓣膜受累臨床分析. 中華風濕病學雜志, 2016, 20(3): 154-159.
6.	曾綺嫻, 柳志紅, 何建國, 等. 多發性大動脈炎累及肺動脈所致肺動脈高壓患者的臨床特征. 中華醫學雜志, 2016, 96(16): 1252-1255.
7.	Fujita K, Nakashima K, Kanai H, et al. A successful surgical repair of pulmonary stenosis caused by isolated pulmonary Takayasu’s arteritis. Heart Vessels, 2012, 28(2): 264-267.
8.	Toledano K, Guralnik L, Lorber A, et al. Pulmonary arteries involvement in Takayasu’s arteritis: two cases and literature review. Semin Arthritis Rheum, 2011, 41(3): 461-470.
9.	楊麗睿, 張慧敏, 蔣雄京, 等. 566 例大動脈炎患者的臨床特點及預后. 中國循環雜志, 2015, 30(9): 849-853.
10.	鄒玉寶, 蔣雄京. 大動脈炎的研究現狀與進展. 中國循環雜志, 2016, 31(8): 822-824.
11.	姜林娣. 迎接大動脈炎精準診治時代到來. 中華醫學雜志, 2016, 96(27): 2121-2123.
12.	Kerr GS, Hallahan CW, Giordano J, et al. Takayasu’s arteritis. Ann Intern Med, 1994, 120(11): 919-929.
13.	熊長明, 柳志紅, 何建國, 等. 41例肺血管炎臨床分析. 中國循環雜志, 2010, 25(1): 44-46.
14.	Paul JF, Fiessinger JN, Sapuval M, et al. Follow-up electron beam CT for the management of early phase Takayasu arteritis. J Comput Assist Tomogr, 2001, 25(6): 924-931.
15.	Kissin EY, Merkel PA. Diagnostic imaging in Takayasu’s arteritis. Curr Opin Rheumatol, 2004, 16(1): 31-37.
16.	呂蓉, 于長路, 李劍. 大動脈炎累及肺動脈患者的 CT 表現及臨床相關性分析. 中華醫學雜志, 2017, 97(23): 1796-1800.
17.	熊長明. 如何鑒別肺血管炎和肺血栓栓塞癥. 中國循環雜志, 2007, 22(3): 232-233.
18.	Tyagi S, Mehta V, Kashyap R, et al. Endovascular stent implantation for severe pulmonary artery stenosis in aortoarteritis (Takayasu’s arteritis). Catheter Cardiovasc Interv, 2004, 61(2): 281-285.
19.	Nakajima N, Masuda M, Imamaki M, et al. A case of pulmonary artery bypass surgery for a patient with isolated Takayasu pulmonary arteritis and a review of the literature. Ann Thorac Cardiovasc Surg, 2007, 13(4): 267-271.

1. Zheng DY, Liu LS, Fan DJ. Clinical studies in 500 patients with aortoarteritis. Chin Med J (Engl), 1990, 103(7): 536-540.
2. Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum, 1990, 33(8): 1129-1134.
3. 姜維, 呂秀章, 楊媛華, 等. 超聲心動圖評價大動脈炎肺動脈受累患者右心功能的臨床研究. 中國超聲醫學雜志, 2016, 32(6): 517-519.
4. 楊明, 曾勇, 沈珠軍, 等. 大動脈炎累及冠狀動脈的臨床特點及介入治療效果分析. 中華醫學雜志, 2014, 94(24): 1874-1877.
5. 孫菲, 梅慧敏, 田新平, 等. 大動脈炎心臟瓣膜受累臨床分析. 中華風濕病學雜志, 2016, 20(3): 154-159.
6. 曾綺嫻, 柳志紅, 何建國, 等. 多發性大動脈炎累及肺動脈所致肺動脈高壓患者的臨床特征. 中華醫學雜志, 2016, 96(16): 1252-1255.
7. Fujita K, Nakashima K, Kanai H, et al. A successful surgical repair of pulmonary stenosis caused by isolated pulmonary Takayasu’s arteritis. Heart Vessels, 2012, 28(2): 264-267.
8. Toledano K, Guralnik L, Lorber A, et al. Pulmonary arteries involvement in Takayasu’s arteritis: two cases and literature review. Semin Arthritis Rheum, 2011, 41(3): 461-470.
9. 楊麗睿, 張慧敏, 蔣雄京, 等. 566 例大動脈炎患者的臨床特點及預后. 中國循環雜志, 2015, 30(9): 849-853.
10. 鄒玉寶, 蔣雄京. 大動脈炎的研究現狀與進展. 中國循環雜志, 2016, 31(8): 822-824.
11. 姜林娣. 迎接大動脈炎精準診治時代到來. 中華醫學雜志, 2016, 96(27): 2121-2123.
12. Kerr GS, Hallahan CW, Giordano J, et al. Takayasu’s arteritis. Ann Intern Med, 1994, 120(11): 919-929.
13. 熊長明, 柳志紅, 何建國, 等. 41例肺血管炎臨床分析. 中國循環雜志, 2010, 25(1): 44-46.
14. Paul JF, Fiessinger JN, Sapuval M, et al. Follow-up electron beam CT for the management of early phase Takayasu arteritis. J Comput Assist Tomogr, 2001, 25(6): 924-931.
15. Kissin EY, Merkel PA. Diagnostic imaging in Takayasu’s arteritis. Curr Opin Rheumatol, 2004, 16(1): 31-37.
16. 呂蓉, 于長路, 李劍. 大動脈炎累及肺動脈患者的 CT 表現及臨床相關性分析. 中華醫學雜志, 2017, 97(23): 1796-1800.
17. 熊長明. 如何鑒別肺血管炎和肺血栓栓塞癥. 中國循環雜志, 2007, 22(3): 232-233.
18. Tyagi S, Mehta V, Kashyap R, et al. Endovascular stent implantation for severe pulmonary artery stenosis in aortoarteritis (Takayasu’s arteritis). Catheter Cardiovasc Interv, 2004, 61(2): 281-285.
19. Nakajima N, Masuda M, Imamaki M, et al. A case of pulmonary artery bypass surgery for a patient with isolated Takayasu pulmonary arteritis and a review of the literature. Ann Thorac Cardiovasc Surg, 2007, 13(4): 267-271.

Chinese Journal of Respiratory and Critical Care Medicine

The analysis of the clinical records diagnosed as Takayasu’s arteritis with pulmonary vascular involvement

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