DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160411

A rare case of Takayasu’s arteritis in pregnancy

Sanjay Singh, Uttara Aiyer Kohli, Manash Biswas, Moman Singh

Abstract


Takayasu’s arteritis (TA) is an uncommon, chronic inflammatory vascular disease of unknown etiology that primarily involves aorta and its branches and pulmonary arteries. Though it is present worldwide, it is more prevalent in Asian countries. It usually presents during reproductive age group with non-specific symptoms. The symptoms of the disease are varied and patients can present asymptomatically with impalpable pulses. There are no specific laboratory tests to diagnose TA. Angiographic imaging is considered to be the gold standard investigation in diagnosing TA. Steroids with subsequent tapering doses are the mainstay of medical treatment. Reconstructive vascular surgery is limited to the severe and irreversible stenotic lesions. Though the disease process theoretically is not aggravated by the pregnancy, development of preeclampsia and fetal growth restriction may occur during pregnancy. Preconception counseling and careful monitoring of pregnant mother by a multidisciplinary team, improves the pregnancy outcome. Here we present a bad obstetric case with TA who subsequently developed severe preeclampsia and fetal growth restriction. The pregnancy outcome could be made favourable by strict monitoring and multidisciplinary team approach.

Keywords


Takayasu’s arteritis, Pregnancy, Preeclampsia, Fetal growth restriction

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References


Vidhate M, Garg RK, Yadav R, Kohli N, Naphade P, Anuradha HK. An unusual case of Takayasu's arteritis: Evaluation by CT angiography. Ann Indian Acad Neurol. 2011;14(4):304-6.

Ishikawa K. Natural history and classification of occlusive thromboaortopathy (Takayasu’s disease). Circulation. 1978;57:27-35.

Walker BR, Colledge NR, Ralston SH, Penman ID. Davidson’s principles & practice of medicine. 22th ed. India: Elsevier; 2014.

Sise MJ, Counihan CM, Shackford SR, Rowley WR. The clinical spectrum of Takayasu's arteritis. Surgery. 1988;104:905-10.

Mukhtyar C, Guillevin L, Cid MC, Dasgupta B, de Groot K, Gross W, et al. EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2009;68:318-23.

Takayasu M. A case with peculiar changes of the retinal central vessels (in Japanese). Acta Soc Ophthal Jpn. 1908;12:554-5.

Watts R, Al-Taiar A, Mooney J, Scott D, Macgregor A. The epidemiology of Takayasu arteritis in the UK. Rheumatol. 2009;48(8):1008-11.

Lupi-Herrera E, Sanchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE. Takayasu’s arteritis. Clinical study of 107 cases. Am Heart J. 1977;93(1):94-103.

Saab F, Giugliano RP, Giugliano GR. Takayasu arteritis in a young woman: a 4-year case history. Tex Heart Inst J. 2009;36(5):470-4.

Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, et al. Takayasu arteritis. Ann Intern Med. 1994;120:919-29.

Matsumura A, Moriwaki R, Numano F. Pregnancy in Takayasu arteritis from the view of internal medicine. Heart Vessels. 1992;7(Suppl):120-4.

Mahmood T, Dewart PJ, Ralston AJ, Elstein M. Three successive pregnancies in a patient with Takayasu’s arteritis. J Obstet Gynaecol. 1997;17:52-4.

Vitthala S, Misra P. Takayasu's Arteritis & Pregnancy: A Review. The Internet Journal of Gynecology and Obstetrics. 2007;9(2).