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.	姜维, 吕秀章, 杨媛华, 等. 超声心动图评价大动脉炎肺动脉受累患者右心功能的临床研究. 中国超声医学杂志, 2016, 32(6): 517-519.
4.	杨明, 曾勇, 沈珠军, 等. 大动脉炎累及冠状动脉的临床特点及介入治疗效果分析. 中华医学杂志, 2014, 94(24): 1874-1877.
5.	孙菲, 梅慧敏, 田新平, 等. 大动脉炎心脏瓣膜受累临床分析. 中华风湿病学杂志, 2016, 20(3): 154-159.
6.	曾绮娴, 柳志红, 何建国, 等. 多发性大动脉炎累及肺动脉所致肺动脉高压患者的临床特征. 中华医学杂志, 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.	杨丽睿, 张慧敏, 蒋雄京, 等. 566 例大动脉炎患者的临床特点及预后. 中国循环杂志, 2015, 30(9): 849-853.
10.	邹玉宝, 蒋雄京. 大动脉炎的研究现状与进展. 中国循环杂志, 2016, 31(8): 822-824.
11.	姜林娣. 迎接大动脉炎精准诊治时代到来. 中华医学杂志, 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.	熊长明, 柳志红, 何建国, 等. 41例肺血管炎临床分析. 中国循环杂志, 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.	吕蓉, 于长路, 李剑. 大动脉炎累及肺动脉患者的 CT 表现及临床相关性分析. 中华医学杂志, 2017, 97(23): 1796-1800.
17.	熊长明. 如何鉴别肺血管炎和肺血栓栓塞症. 中国循环杂志, 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. 姜维, 吕秀章, 杨媛华, 等. 超声心动图评价大动脉炎肺动脉受累患者右心功能的临床研究. 中国超声医学杂志, 2016, 32(6): 517-519.
4. 杨明, 曾勇, 沈珠军, 等. 大动脉炎累及冠状动脉的临床特点及介入治疗效果分析. 中华医学杂志, 2014, 94(24): 1874-1877.
5. 孙菲, 梅慧敏, 田新平, 等. 大动脉炎心脏瓣膜受累临床分析. 中华风湿病学杂志, 2016, 20(3): 154-159.
6. 曾绮娴, 柳志红, 何建国, 等. 多发性大动脉炎累及肺动脉所致肺动脉高压患者的临床特征. 中华医学杂志, 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. 杨丽睿, 张慧敏, 蒋雄京, 等. 566 例大动脉炎患者的临床特点及预后. 中国循环杂志, 2015, 30(9): 849-853.
10. 邹玉宝, 蒋雄京. 大动脉炎的研究现状与进展. 中国循环杂志, 2016, 31(8): 822-824.
11. 姜林娣. 迎接大动脉炎精准诊治时代到来. 中华医学杂志, 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. 熊长明, 柳志红, 何建国, 等. 41例肺血管炎临床分析. 中国循环杂志, 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. 吕蓉, 于长路, 李剑. 大动脉炎累及肺动脉患者的 CT 表现及临床相关性分析. 中华医学杂志, 2017, 97(23): 1796-1800.
17. 熊长明. 如何鉴别肺血管炎和肺血栓栓塞症. 中国循环杂志, 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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