Takayasu动脉炎(TA)是一种病因不明的自身免疫实体,可引起大中型动脉肉芽肿性增厚。常见症状包括跛行,头痛,头晕,晕厥,视觉变化,还有心悸.不同的心脏表现,比如缺血性心脏病,显著的主动脉瓣反流,肺动脉高压,与TA相关联,尽管它们很少表现为充血性心力衰竭。无线电成像,包括CT血管造影和MR血管造影,随着更具侵入性的程序,如传统的血管造影,通常用于诊断。用皮质类固醇治疗,类固醇保护剂,生物制剂,和血运重建程序。这里,有一例17岁的印度女性主诉腹痛.几年前她被诊断出患有桥本甲状腺炎,还有充血性心力衰竭的病史.在一般检查中,由于双侧颈动脉杂音的存在,上肢的血压不对称。所有四肢的伸肌表面也存在广泛的鳞片状病变,提示牛皮癣。放射成像证实了TA的诊断。CT血管造影还显示腹腔干和胃左动脉近端完全闭塞,这可能是她症状的原因.患者接受皮质类固醇联合甲氨蝶呤治疗,以及其他支持性药物。TA伴充血性心力衰竭在文献中偶尔有描述,而TA与牛皮癣的关联更为罕见。各种自身免疫性疾病的同时发生是常见的,但是桥本甲状腺炎的三合会,牛皮癣,与心脏衰竭的初始表现是独特的。由于自身免疫性疾病的共同发生,为了获得最佳的健康结果,必须进行早期和全面的患者评估和全面的研究。
Takayasu arteritis (TA) is an autoimmune entity of unknown aetiology causing granulomatous thickening of large and medium-sized arteries. Common symptoms include claudication, headaches, dizziness, syncope, visual changes, and palpitations. Diverse cardiac manifestations, such as ischemic heart disease, significant aortic regurgitation, and pulmonary hypertension, are associated with TA, although they rarely manifest as congestive heart failure. Radio-imaging, including CT angiography and MR angiography, along with more invasive procedures such as conventional angiography, are often used for diagnosis. Treatment is done with corticosteroids, steroid-sparing agents, biologics, and revascularization procedures. Here, we have a case of a 17-year-old Indian female who presented to us with a complaint of abdominal pain. She was diagnosed with Hashimoto\'s thyroiditis a few years ago, along with a history of congestive heart failure. On general examination, blood pressure was asymmetrical in the upper limbs with the presence of bilateral carotid bruit. There was also the presence of extensive scaly lesions on the extensor surface of all four limbs, suggestive of
psoriasis. Radio-imaging confirmed the diagnosis of TA. CT angiography also showed total occlusion of the celiac trunk and proximal left gastric artery, which was likely the cause of her symptoms. The patient received treatment with corticosteroids in conjunction with methotrexate, along with other supportive drugs. TA with congestive heart failure has been occasionally described in the literature, while the association of TA with
psoriasis is much rarer. The simultaneous occurrence of various autoimmune diseases is common, but the triad of Hashimoto thyroiditis,
psoriasis, and TA with an initial presentation of heart failure is unique. Due to the common co-occurrence of autoimmune conditions, early and thorough patient evaluation with comprehensive studies is imperative for optimal health outcomes.