Presentation
Bilateral lesions and renal functional impairment at presentation were significantly predictive of poor outcomes. [jrheum.org]
A carotid bruit was present on the left, a 2/6 systolic blowing murmur along the right sternal border, a bruit present left of the umbilicus and a diminished left radial pulse. [openurologyandnephrologyjournal.com]
We report a case of a previously healthy 54-year-old white woman who presented with nonoliguric renal failure and a 4-week history of persistent low-grade fever associated with diffuse mild myalgias. [pubmed.ncbi.nlm.nih.gov]
Presenting demographics and disease parameters are summarized in Table 1. [acrabstracts.org]
February 1964 Arch Intern Med. 1964;113(2):230-234. doi:10.1001/archinte.1964.00280080066013 Full Text The generalized but patchy arteritis of the elderly which usually presents as temporal arteritis and which is characterized by a granulomatous reaction [jamanetwork.com]
Entire Body System
- Fever
A 64-year-old woman with hypertension and hyperlipidemia was admitted to our hospital for the investigation and management of general fatigue, anorexia, a 5-kg weight loss, and a 4-week history of high-grade fever. [ncbi.nlm.nih.gov]
Abstract A 64-year-old woman with hypertension and hyperlipidemia was admitted to our hospital for the investigation and management of general fatigue, anorexia, a 5-kg weight loss, and a 4-week history of high-grade fever. [jstage.jst.go.jp]
We report a case of a previously healthy 54-year-old white woman who presented with nonoliguric renal failure and a 4-week history of persistent low-grade fever associated with diffuse mild myalgias. [pubmed.ncbi.nlm.nih.gov]
- Malaise
[…] multinucleated giant cells Can produce either luminal compromise (more common) or dilatation and aneurysms Us. young women, most often Asian or European background, us. onset age 10-30y Initial presentation includes fever, arthralgias, arthritis, and malaise [faculty.washington.edu]
Comment: In summary, this 73 year old male with a three month history of constitutional symptoms including weight loss, night sweats, fatigue and malaise presents with rapidly progressive acute renal failure, hemoptysis and diffuse bilateral pulmonary [path.upmc.edu]
Constitutional symptoms may include weight loss, malaise, fever, depression, and polymyalgia rheumatica, night sweats [1] [5] [6] [10] [4]. [physio-pedia.com]
Takayasu's arteritis affects the thoracic and abdominal aorta and its main branches or the pulmonary arteries. 17 It primarily affects young women, particularly of Asian descent, and may be manifested by malaise, arthralgias and the gradual onset of extremity [aafp.org]
Systemic symptoms occur to 20-80% of patients and are characterized by fatigue, malaise, weight loss, arthralgias, and myalgias. [rheumatologyadvisor.com]
- Rapidly Progressive Glomerulonephritis
Contributor's Note: Crescentic glomerulonephritis or rapidly progressive glomerulonephritis (RPGN) is a term given to a diverse group of diseases which all have cresents present within the glomerular tuft (Table 1). [path.upmc.edu]
Renal involvement may present as a rapidly progressive glomerulonephritis(GN) with renal biopsy showing a pauci-immune crescentic GN. [rarerenal.org]
Confusingly, approximately 5% of pauci-immune, crescentic glomerulonephritis is ANCA negative at diagnosis. The typical presentation of renal vasculitis is that of a rapidly progressive glomerulonephritis. [cjasn.asnjournals.org]
Cardiovascular
- Hypertension
Takayasu arteritis associated renal artery stenosis (TARAS) is the biggest cause of hypertension in young people <40 years old. Hypertension caused by renal artery stenosis is usually hard to control in spite of two or more anti-hypertension drugs. [clinicaltrials.gov]
Pittsburg, PA, USA 3 Division of Nephrology and Hypertension W.G. [openurologyandnephrologyjournal.com]
In conclusion, renal artery stenosis should always be kept in mind in Takayasu arteritis with hypertension. [ard.bmj.com]
Case study, Radiopaedia.org (Accessed on 26 Nov 2022) https://doi.org/10.53347/rID-10240 Case of the day: 08 Nov 2010 Inclusion in quiz mode: Included Presentation Young hypertensive woman, referred for evaluation of hypertension. [radiopaedia.org]
Brolin I (2016) Renal Artery Changes in Hypertension, Acta Radiologica. Diagnosis, 10.1177/028418516700600501, 6:5, (401-423), Online publication date: 1-Sep-1967. [ahajournals.org]
- Vascular Disease
In the clinical trials of peripheral vascular disease, it has been confirmed that DCB had lower re-stenosis rate than PTA. However, up to date, no studies was found about the use of DBC in TARAS. [clinicaltrials.gov]
Vascular Manifestations of Systemic Autoimmune Diseases not only describes the clinical symptoms of vascular diseases; it also covers in one volume the many mechanisms involved in the pathogenesis of these disorders and addresses the newest treatments [books.google.de]
What is renal vascular disease? Renal vascular disease is the name given to a variety of complications that affect the arteries and veins of the kidneys. [unmc.edu]
Brest A, Heider C and Moyer J (1962) Renal vascular disease as a cause of hypertension∗, The American Journal of Cardiology, 10.1016/0002-9149(62)90136-4, 9:5, (748-755), Online publication date: 1-May-1962. [ahajournals.org]
The immunosuppressive therapy did not halt the progression of her vascular disease, which required revascularization procedures on numerous occasions. [openurologyandnephrologyjournal.com]
- Tachycardia
The patient's workup showed a pulse rate of 104 beats/min, cardiomegaly and signs of cephalization on chest X-ray [Figure 1], and sinus tachycardia on electrocardiography. [rcvmonline.com]
She continued under medical care at a basic healthcare unit in her own district, where she used to present nonspecific symptoms such as fatigue, diffuse arthralgia, dizziness, intermittent claudication, diffuse myalgia, tachycardia, and depressive symptoms [scielo.br]
Urogenital
- Oliguria
The patient worsened significantly six months after the onset of symptoms and developed acute pulmonary edema, oliguria, acute kidney injury, and difficult-to-control hypertension, at which point she was admitted for intensive care and hemodialysis. [bjnephrology.org]
In one of these visits, she complained of recent oliguria, slowness, drowsiness and hair loss. Her laboratory tests showed TSH 66.09 mIU/L; free T 4 of 0.53 ng/dL; creatinine of 5.58 mg/dL and urea of 172 mg/dL. [scielo.br]
STEC-HUS : This form, also called the classical form, presents after or during an episode of diarrheal disease, there is acute renal failure with oliguria, proteinuria, hematuria, anemia and thrombocytopenia. [kidneypathology.com]
Workup
Progress logically from the histologic pattern, through the appropriate workup, around the pitfalls, to the best diagnosis. [books.google.es]
Serological workup revealed a high-titre perinuclear antinuclear cytoplasmic antibody and antibodies to myeloperoxidase. Renal biopsy demonstrated a pauci-immune focal crescentic glomerulonephritis. [casereports.bmj.com]
Initial workup revealed BUN 62mg/dl, creatinine 2.8mg/dl, random urine protein 76mg/dl with 24-hour urine protein 576mg but no urine RBCs, ESR 81mm/hr, CRP 170mg/l, total CPK 245u/l, and positive MPO-ANCA with titer >8. [shmabstracts.com]
The patient's workup showed a pulse rate of 104 beats/min, cardiomegaly and signs of cephalization on chest X-ray [Figure 1], and sinus tachycardia on electrocardiography. [rcvmonline.com]
Angiography-based categories Takayasu arteritis can be divided into the following six types based on angiographic involvement (see Workup ) [3] : Type I - Branches of the aortic arch Type IIa - Ascending aorta, aortic arch, and its branches Type IIb - [emedicine.medscape.com]
X-Ray
- Small Kidney
The clinical significance of arteritis of the small kidney arteries has not been evaluated in detail. [jasn.asnjournals.org]
As a result, there are increased blood levels of the hormone angiotensin 2, which causes narrowing of the small blood vessels in the kidneys. [medicinenet.com]
Serum
- Creatinine Decreased
Izzedine et al. suggest the possibility to continue ICPI in case of a grade 1 renal event and to postpone the treatment until plasma creatinine decreases to at least grade 1, in case of grade 2–3 renal event [2]. [bmcnephrol.biomedcentral.com]
Treatment
In addition, the prognosis of TA has improved with the available treatment modalities [14]. [openurologyandnephrologyjournal.com]
The efficacy of glucocorticoids in the treatment of AIN remains controversial in the absence of randomized trials. [bmcnephrol.biomedcentral.com]
Because this study was retrospective in design and without a control group, treatment strategies were not randomized. [jrheum.org]
Treatment with methylprednisolone and cyclophosphamide achieved normalization of renal function. We emphasize the importance of kidney biopsy because of its therapeutic implications. [portalcientifico.uam.es]
Diagnosis and surgical treatment of a Takayasu disease on an abdominal aortic dissection. Ann Vasc Surg 2011; 25: 556.e1-5. Ando M, Okita Y, Tagusari O, Kitamura S, Matsuo H. [termedia.pl]
Prognosis
AAV_A+ patients were distributed in all categories of the current prognosis’ classification. [jasn.asnjournals.org]
In addition, the prognosis of TA has improved with the available treatment modalities [ 14 Ohigashi H, Haraguchi G, Konishi M. [benthamopen.com]
Our results suggest renal prognosis is better than previously thought. Disclosure: C. Baldwin, None; A. Mohammad, None; D. [acrabstracts.org]
One study suggested that a low ESR, early treatment with steroids and a stable condition at presentation were factors which predicted a good prognosis. [ 17 ] [patient.info]
[…] presentation of TA, we recommend a high clinical index of suspicion of renal artery involvement and sufficient heed to its significance especially in view of the fact that its early diagnosis and timely appropriate treatment can confer a much better prognosis [rcvmonline.com]
Etiology
CONCLUSIONS The specific etiology and pathophysiology of TA remain largely obscure. Since its historic description to the present time, there have beenonly a few treatment strategies available for TA. [openurologyandnephrologyjournal.com]
Etiology The etiology of Takayasu arteritis is unknown. [emedicine.medscape.com]
Persistent perplexing pyrexia: some comments on etiology and diagnosis. Med Clin North Am. 1970 Mar; 54 (2):379–396. [ PubMed ] [ Google Scholar ] Barbado FJ, Vázquez JJ, Peña JM, Arnalich F, Ortiz-Vázquez J. [ncbi.nlm.nih.gov]
Since then, this procedure has been performed successfully several times and become the alternative treatment to the surgical approach with better results in pediatric patients. [7] To sum up, TA with renal artery involvement must be regarded as an etiologic [rcvmonline.com]
Presumed to be due to etiologies similar to those responsible for native kidney glomerulonephritis Hyperacute Rejection Rejection presumed to be due to preformed antibody, usually characterized by polymorph accumulation in glomerular and peritubular capillaries [tpis.upmc.com]
Epidemiology
In this review, we present the epidemiology, clinical manifestations, diagnosis and treatment of Takayasu's arteritis with particular emphasis on renal artery stenosis. [ncbi.nlm.nih.gov]
Epidemiology of Takayasu arteritis. Presse Med 2017;46:e197-e203. 4. Jokar MH, Takayasu arterities in Iran. SAS J Med 2016;2:64-8. 5. Valente ES, de Almeida R, Sacco AG, Lazzarin MC, da Silva AM, Andreazza M, et al. [rcvmonline.com]
Takayasu's arteritis was first described by Mikito Takayasu in 1908. [ 3 ] Epidemiology [ 3 ] Takayasu's arteritis is rare. [patient.info]
Pathophysiology
Written by leading pathologists, this second edition presents an up-to-date, concise presentation of major pathological, clinical, pathophysiological, and genetic information for over 240 diagnoses. [books.google.es]
From basic science and pathophysiology to clinical best practices, Brenner & Rector’s The Kidney is your go-to resource for any stage of your career. [books.google.com]
Large artery vasculitides Takayasu's arteritis Pathophysiology Involves the aorta (us. the most severely affected vessel) and its primary branches, including renal and mesenteric aa. [faculty.washington.edu]
Even though ANCA were negative, we may suppose that pathophysiology of renal granulomatous arteritis in our patient was directly linked to CTLA-4 blocking. Management of ICPIs-induced AKI is still challenging. [bmcnephrol.biomedcentral.com]
Prevention
An antiplatelet agent was prescribed to prevent thrombotic complications. At 3 months after initiation of treatment, the patient remained normotensive. [ped-rheum.biomedcentral.com]
Appropriate local and systemic therapy has to be initiated for other organ manifestations and to prevent recurrence of the disease. [academic.oup.com]
[…] disease if you have: Diabetes Family history of kidney disease Heart disease High blood pressure High cholesterol African Americans are about 3.5 times more likely to develop kidney disease than Caucasians, according to the Centers for Disease Control and Prevention [arthritis.org]
Treatment is usually 9 months)-->they may feel immediate relief - Add cyclophosphamide (Cytoxan-prevents cell division) if not improving on steroids alone but they can't have Hep B -ACEI for renal HTN [quizlet.com]