Presentation
A 45-year-old female was presented with progressive dyspnea and bilateral leg edema. Pulmonary angiography revealed total occlusion of the right pulmonary artery and significant stenosis of the left pulmonary artery. [ncbi.nlm.nih.gov]
Nuclear atypia was not present and no microorganisms were seen. [journalpulmonology.org]
Nevertheless, it presented as the initial isolated presentation is seldom seen. [scielo.br]
The authors present a case involving a 48-year-old First Nations man presenting with a six-month history of exertional dyspnea and severe stenosis of the left pulmonary artery, who was ultimately diagnosed with pulmonary arteritis related to large vessel [ingentaconnect.com]
Entire Body System
- Fatigue
She had also experienced recurrent syncope on exertion and complained of occasional burning chest pain and vague fatigue. [karger.com]
These mostly include chest pain, cough, signs of pulmonary hypertension such as dyspnea, fatigue, angina, syncope [ 28 – 31 ], and hemoptysis [ 32, 33 ], with rare cases of pulmonary hemorrhage [ 34 – 36 ]. [thoracickey.com]
About 50% of patients report constitutional symptoms such as fever, malaise, night sweats, weight loss, fatigue, and/or arthralgias. Repetitive arm movements and sustained arm elevation may cause pain and fatigue. [msdmanuals.com]
Symptoms: Some of the early signs of cor pulmonale include constant cough, difficulty breathing, fatigue and weakness. [medigoo.com]
For this reason the oxygenated blood circulation is less in the organs and tissues and following symptoms arise: During any type of physical activity, the upper or lowers limbs become easily fatigue and pain symptoms started. [medicalfoxx.com]
- Soft Tissue Mass
Fig. 2 Ultrasound-guided transbronchial fine-needle aspiration of the soft-tissue mass around the right pulmonary artery contains exclusively normal lymphatic tissue cells with anthracotic pigment containing histiocytes (arrows). [karger.com]
Respiratoric
- Rales
[…] snap僧帽弁開放音 mitral regurgitation (MR)僧帽弁逆流[症] mitral stenosis (MS) 僧帽弁狭窄[症] mitral valve 僧帽弁 mitral valve area僧帽弁口面積 mitral valve prolapse (MVP)僧帽弁逸脱[症] mitral valve replacement僧帽弁置換術 Mobitz type I blockモビッツI型ブロック Mobitz type II blockモビッツII型ブロック moist rale [tokyo-med.ac.jp]
Cardiovascular
- Ejection Murmur
Auscultation of the lung was normal, while cardiac auscultation revealed a harsh 3/6 systolic ejection murmur with radiation to the back. A diagnostic workup was initiated. [karger.com]
Workup
/takayasus-arteritis/ by David Hellmann, M.D. http://www.medicinenet.com/takayasu_disease/article.htm http://www.mayoclinic.org/diseases-conditions/takayasus-arteritis/basics/symptoms/con-20028085 Takayasu’s Arteritis -> Overview, Presentation, DDx, Workup [medicalfoxx.com]
A diagnostic workup was initiated. Echocardiography showed normal right ventricular systolic function with no evidence of pulmonary arterial hypertension. [karger.com]
The patient was admitted to hospital and given a diagnostic workup. Abdomen ultrasound (USS) showed signs of hepatic steatosis and a poorly defined nodular area in the IV segment. No abnormalities could be detected on chest X-ray. [journalpulmonology.org]
Extensive workup ruled out any ongoing infectious disease. [thoracickey.com]
X-Ray
- Mediastinal Mass
On chest computed tomography, the wall of the right pulmonary artery was thickened and surrounded by infiltrative mediastinal masses; there were no signs of a currently active tuberculosis (TB) infection. [karger.com]
Serum
- Oxygen Saturation Decreased
However, on a bicycle stress test the patient managed a workload of 85% predicted when oxygen saturation decreased to 85% on ambient air. [karger.com]
Microbiology
- Treponema Pallidum
Laboratory tests revealed a high erythrocyte sedimentation rate (ESR, 81 mm/h), a mildly elevated C-reactive protein (15-25 mg/L, normal range Treponema pallidum particle agglutination assay, hepatitis C virus, antineutrophil cytoplasmic antibodies, antinuclear [karger.com]
Treatment
Patients treated with Actemra who develop a serious infection should stop that treatment until the infection is controlled. Live vaccines should be avoided during treatment with Actemra. [fda.gov]
The lesions resolved after two months of steroid treatment. This case shows that we should be aware of atypical GCA manifestations. [journalpulmonology.org]
For the vast majority of people with vasculitis, treatment is very effective. [resources.lupus.org]
High-dose methylprednisolone treatment (2.5 g over 3 days) was initiated, and methotrexate was started with rapid dose escalation to 20 mg weekly, replacing azathioprine. [karger.com]
Standard Therapies Treatment The treatment of giant cell arteritis should start when the diagnosis is suspected. Prompt treatment may help to avoid serious complications such as blindness and coronary blockage (occlusion). [rarediseases.org]
Prognosis
Key Indexing Terms: TAKAYASU ARTERITIS PULMONARY HYPERTENSION PROGNOSIS VASCULITIS Footnotes Supported by the National Natural Science Foundation of China (grant number: 81170285) and the Research Fund for the Doctoral Program of Higher Education of China [jrheum.org]
Prognosis ILD associated with rheumatoid arthritis causes significant morbidity and mortality. Mortality is high in patients who develop ILD and pulmonary hypertension. [patient.info]
Maksimowicz-McKinnon K, Clark TM, Hoffman GS (2007) Limitations of therapy and a guarded prognosis in an American cohort of Takayasu arteritis patients. Arthritis Rheum 56:1000–1009 PubMed CrossRef Google Scholar 36. [link.springer.com]
Several Turkish studies [ 103, 118 – 121 ] have helped defining the clinical presentation, prognosis and treatment of PAA. This complication can either occur at diagnosis or during the course of BD. [thoracickey.com]
Prognosis Complete cure of takayasu arteritis is not possible, but right diagnosis and early initiation of treatment can prevent the further complication and provide quality of life to the patient. [medicalfoxx.com]
Etiology
Diagnoses of "primary pulmonary arteritis" 2,8 or "pulmonary polyarteritis nodosa" 3,6,7,15 were made, the latter term implying a hyperimmune or allergic etiology. [jamanetwork.com]
The etiology of TA is not clear. A possible relationship between TA and tuberculosis has been suggested. Some studies suggest cross-reaction between Mycobacterium tuberculosis and human heat shock protein. [jneuro.com]
The primary systemic vasculitides are a heterogeneous group of syndromes of unknown etiology, which share a clinical response to immunosuppressive therapy ( Table 74-1 ). [mhmedical.com]
Giant cell arteritis and Takayasu aortitis: morphologic, pathogenetic and etiologic factors. Int J Cardiol 2000;75:21-33. Brugiere O, Mal H, Sleiman C, Groussard O, Mellot F, Fournier M. [archivesofrheumatology.org]
Epidemiology
Articles include: Epidemiology of Pulmonary Arterial Hypertension, Pathology of Pulmonary Hypertension, Genetics of Pulmonary Arterial Hypertension, Diagnosis of Pulmonary Arterial Hypertension, Pulmonary Hypertension Owing to Left Heart Disease, Pulmonary [books.google.com]
One of the typical epidemiological features of TA is the marked predominance of the disease in women, with a F/M sex-ratio known to vary from 29/1 to 1.2/1 [ 3 ]. [thoracickey.com]
Epidemiology Rheumatoid arthritis is often associated with pleural disease (20-40%), interstitial pneumonitis (5-10%), nodules (1%), interstitial fibrosis, bronchiolitis obliterans organising pneumonia, and pulmonary vasculitis. [patient.info]
Little epidemiologic data are available on the occurrence of interstitial lung diseases (ILDs) in the general population. [lungindia.com]
Giant Cell Arteritis Epidemiology and Treatment. Drugs Aging. 1994;4:135-44. Kyle V et al. The clinical and laboratory course of polymyalgia rheumatica/giant cell arteritis after the first two months of treatment. Ann Rheum Dis. 1993;52:847-50. [rarediseases.org]
Pathophysiology
[…] chest movement kyphoscolioisis marked obesity neuromuscular diseases Disorders inducing pulmonary arterial constriction metabolic acidosis hypoxemia chronic altitiude sickness major airway obstruction idiopathic alveolar hypoventilation return to top Pathophysiology [sharinginhealth.ca]
Pathophysiology In this disease, vasculities developed in aorta or its branches which followed a lesion development which is described as a panarteritis with intimal proliferation. [medicalfoxx.com]
Gershwin Giant cell arteritis: a review of classification, pathophysiology, geoepidemiology and treatment [3] G.S. Hoffman Giant cell arteritis [4] P. Manganelli, P. Fietta, M. Carotti, A. Pesci, F. [journalpulmonology.org]
Arnaud L, Kahn J-E, Girszyn N, Piette AM, Bletry O (2006) Takayasu’s arteritis: an update on pathophysiology. Eur J Intern Med 17:241–246 PubMed CrossRef Google Scholar 4. Seko Y (2007) Giant cell and Takayasu’s arteritis. [link.springer.com]
(See Pathophysiology .) Age and female sex are established risk factors for GCA, a genetic component seems likely, and infection may have a role (see Etiology ). [emedicine.medscape.com]
Prevention
The aim of the treatment of takayasu arteritis is to prevention of further narrowing of the arteries by controlling the vasculities. [medicalfoxx.com]
The report was short on advice about what to do to prevent VTE in GCA, but the investigators did recommend “adequate monitoring ... for early recognition of this potentially serious complication.” [mdedge.com]
[…] problem like indigestion or a stomach ulcer, which can be a side effect of taking prednisolone bisphosphonate therapy – to reduce the risk of osteoporosis when taking prednisolone immunosuppressants – to allow steroid medication to be reduced and help prevent [nhs.uk]
Preventive measures may include: Bed rest, low salt diet, a small amount of fluids, diuretics. Disclaimer : The above information is educational purpose. [medigoo.com]
Prompt diagnosis and treatment is essential to prevent devastating complications, such as blindness, stroke and aortic aneurysm or dissection. Typical symptoms include headache, temporal artery tenderness and jaw claudication. [journalpulmonology.org]