Two Cases of Secondary Hypertension with Rare Aetiology

Secondary Hypertension comprises approximately 5% of Systemic Hypertension1. Renal parenchymal, Renovascular and Endocrine Diseases are amongst the common causes of Secondary Hypertension. Takayasu,s Arteritis is a rare form of Primary Systemic Vasculitis that appears to be commoner in Asia than Europe or North America2 and in contrast to Japanese patients, who have a higher incidence of aortic arch involvement, the series from India reports higher incidences of thoracic and abdominal involvement. In general, patients from Indian subcontinent tend to have greater prevalence of Pan-aortic Disease (both above and below the diaphragm) when compared with the west. In India the women : men ratio is around 1.5:1. Takayasu, s Arteritis most frequently affects young women3. Therapeutic intervention like Percutaneous Transluminal Angioplasty (PTA) and Stenting, By-pass Surgeries or surgical reconstruction should be performed when disease is made inactive by the use of effective immunosuppressive Therapy4

Takayasu Arteritis in an Older Man with Pulmonary Embolism / General Medicine

An 85-year-old male patient with a history of asthma and hypertension was admitted to our hospital because of a fever of unknown origin. He complained of fever, fatigue, and weakness of lower extremities, which was considered due to infection, and he was administered antibiotics. Although his fever improved, there was little improvement in his condition or laboratory data. Enhanced-contrast computed tomography showed irregular hypertrophy of the aorta with contrast effect in the outer aortic wall and pulmonary embolism. He was diagnosed with Takayasu arteritis and pulmonary embolism. His clinical condition and aortic wall enhancement improved following steroid and anticoagulant drug therapy.

A Case of Takayasu Arteritis in a Patient with Juvenile Onset Ankylosing Spondylitis / 대한류마티스학회지

Juvenile onset ankylosing spondylitis is a chronic inflammatory arthritis showing oligoarthritis and enthesopathy of the peripheral and axial skeleton. This have been shown to have different clinical presentation and outcome from adult onset ankylosing spondylitis. Takayasu arteritis is a uncommon, chronic inflammatory disease of elastic arteries such as the aorta, its larger branches and the pulmonary artery trunk. Although, it has rare report about association between ankylosing spondylitis and Takayasu arteritis, there was no report of juvenile onset ankylosing spondylitis with Takayasu arteritis. Thereby, we report a patient with Takayasu arteritis who had juvenile onset ankylosing spondylitis in the course of his disease.

A Case of Takayasu's Arteritis Associated with Stenosis of Both Subelavian Arteries and Both Renal Arteries

Takayasu's arteritis(TA) is a nonspecific areritis of unknown etiology affecting segmentally the aorta and its main branches, which result in stenosis, occlusion or aneurysm of involved arteries. The clinical manifestations present with a variety of symptoms such as headache, dyspnea on exertion, pain and weakness of extremities, pulse deficit, and hypertension according to involves arteries. Usually it can be managed by medical or surgical treatment, and recently by percutaneous transluminal balloon angioplasty. The type III classified by Lupi-Herrena and associates is the most frequent variety of TA. However the case of type III involving both subclavin arteries and both renal arteries has rarely been reported. We experienced a case of TA involving both subcalvian arteries, and both renal arteries presented with paroxysmal hypertension and right flank pain, in which the stenosis of both subclavian arteries were managed by percutaneous transluminal balloon angioplasty and the stenosis and occlusion of both renal arteries were successfully managed by aorto-renal bypass surgery with autogenous right iliac artery and synthetic vessel(Gortex). The patient was discharged uneventfully.