open access

Vol 89, No 1 (2021)
Case report
Submitted: 2020-07-01
Accepted: 2020-08-19
Published online: 2020-12-17
Get Citation

Dyspnea in Takayasu arteritis — an ordinary cause with an extraordinary link

Umang Arora1, Advait M Vasavada1, Surabhi Vyas1, Animesh Ray1
DOI: 10.5603/ARM.a2020.0175
·
Pubmed: 33471351
·
Adv Respir Med 2021;89(1):62-67.
Affiliations
  1. All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

open access

Vol 89, No 1 (2021)
CASE REPORTS
Submitted: 2020-07-01
Accepted: 2020-08-19
Published online: 2020-12-17

Abstract

Takayasu arteritis (TA) poses a diagnostic challenge as it may have a myriad of clinical presentations. Dyspnea, as an index presentation in TA, may be secondary to the involvement of the aorta, myocardium, and/or the pulmonary vessels, or can present as a manifestation of pulmonary infection with tuberculosis. Significant lymphadenopathy cannot be attributed to TA and serves to point towards a different diagnosis or concomitant infection. Tuberculosis has been associated with TA and has considerable pathogenic and therapeutic implications. We present a case of a young female with extensive intra-thoracic tubercular lymphadenopathy compressing the trachea and right main bronchus resulting in dyspnea. The patient was subsequently found to have active TA and improved after treatment with anti-tubercular therapy and steroids. We review the causes of dyspnea and mediastinal lymphadenopathy in a patient with TA.

Abstract

Takayasu arteritis (TA) poses a diagnostic challenge as it may have a myriad of clinical presentations. Dyspnea, as an index presentation in TA, may be secondary to the involvement of the aorta, myocardium, and/or the pulmonary vessels, or can present as a manifestation of pulmonary infection with tuberculosis. Significant lymphadenopathy cannot be attributed to TA and serves to point towards a different diagnosis or concomitant infection. Tuberculosis has been associated with TA and has considerable pathogenic and therapeutic implications. We present a case of a young female with extensive intra-thoracic tubercular lymphadenopathy compressing the trachea and right main bronchus resulting in dyspnea. The patient was subsequently found to have active TA and improved after treatment with anti-tubercular therapy and steroids. We review the causes of dyspnea and mediastinal lymphadenopathy in a patient with TA.

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Keywords

Takayasu arteritis; tuberculosis; dyspnea; mediastinal lymphadenopathy

About this article
Title

Dyspnea in Takayasu arteritis — an ordinary cause with an extraordinary link

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 1 (2021)

Article type

Case report

Pages

62-67

Published online

2020-12-17

DOI

10.5603/ARM.a2020.0175

Pubmed

33471351

Bibliographic record

Adv Respir Med 2021;89(1):62-67.

Keywords

Takayasu arteritis
tuberculosis
dyspnea
mediastinal lymphadenopathy

Authors

Umang Arora
Advait M Vasavada
Surabhi Vyas
Animesh Ray

References (11)
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  2. Critchley JA, Orton LC, Pearson F. Adjunctive steroid therapy for managing pulmonary tuberculosis. Cochrane Database Syst Rev. 2014(11): CD011370.
  3. Castillo-Martínez D, Amezcua-Castillo LM, Granados J, et al. Is Takayasu arteritis the result of a Mycobacterium tuberculosis infection? The use of TNF inhibitors may be the proof-of-concept to demonstrate that this association is epiphenomenal. Clin Rheumatol. 2020; 39(6): 2003–2009.
  4. Neidhart B, Kosek R, Bachmann LM, et al. Exertional dyspnea as initial manifestation of Takayasu's arteritis — a case report and literature review. BMC Pulm Med. 2001; 1: 3.
  5. Talwar KK, Kumar K, Chopra P, et al. Cardiac involvement in nonspecific aortoarteritis (Takayasu's arteritis). Am Heart J. 1991; 122(6): 1666–1670.
  6. Alali WM, Alahmari SA, Alhebaishi YS, et al. Severe aortic regurgitation complicating Takayasu's arteritis. Saudi Med J. 2017; 38(8): 863–867.
  7. Saxena A, Sontakke TR, Mishra D, et al. Acute myocardial infarction with left ventricular failure as an initial presentation of Takayasu's arteritis. J Clin Diagn Res. 2016; 10(5): OD27–OD28.
  8. Mally A, D'Souza C, Dwivedi S, et al. Pulmonary tuberculosis with multiple saccular aneurysms of the aorta--a case report. Angiology. 1990; 41(4): 333–336.
  9. Stone JR. Aortitis, periaortitis, and retroperitoneal fibrosis, as manifestations of IgG4-related systemic disease. Curr Opin Rheumatol. 2011; 23(1): 88–94.
  10. Drago F, Merlo G, Rebora A, et al. Syphilitic aortitis and its complications in the modern era. G Ital Dermatol Venereol. 2018; 153(5): 698–706.
  11. Wang L, Omari A, Emmett L, et al. Granulomatous sarcoid aortitis: a serious complication of a well-known multisystem disease. The Lancet. 2015; 385(9981): 2014.

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