A case of ankylosing spondylitis with concurrent Takayasu arteritis

Abstract

We herein report a case involving a 56-year-old man who had experienced neck and lower back pain since the age of 23 years. Ankylosing spondylitis (AS) was diagnosed at 41 years of age, and treatment with sulfasalazine was initiated. At 44 years of age, the patient developed respiratory distress on exertion and chest pain. Aortic regurgitation (AR) was diagnosed via echocardiography, and the patient presented to our hospital for close examination and treatment. Coronary computed tomography angiography revealed no lesions in the coronary artery; however, magnetic resonance angiography revealed stenotic lesions in the left common carotid artery and left subclavian artery. Based on the findings of a physical examination, fundus examination, and blood tests, the patient was diagnosed with AS with concurrent Takayasu arteritis (TA). Upon administration of steroids to alleviate inflammation caused by an autoimmune mechanism, the patient’s chest symptoms and inflammatory findings improved. AR was treated with aortic valve replacement and prosthetic blood vessel replacement, after which the patient progressed well. Intraoperative aortic biopsy revealed findings pathologically consistent with TA. Although AS with concurrent AR is well described, AS with concurrent TA, as in the present case, is rare.

Ankylosing Spondylitis Coexisting With Takayasu’s Arteritis in a Female Patient: A Rare Entity

“…Both AS and TA are uncommon inflammatory conditions, and their coexistence in one individual is even more infrequent. Research has shown that the presence of TA and AS may be coincidental or simultaneous because of certain underlying factors (1,2). AS typically affects the spine, hip, and enthesis, leading to a limited range of motion.…”

“…AS typically affects the spine, hip, and enthesis, leading to a limited range of motion. TA is an inflammatory disease primarily affecting the aorta and its branches, leading to limb claudication pain (1,2,7). CT, MR, and US imaging can detect indications of inflammation, such as arterial thickness and stenosis.…”

“…Stiffness and gradual functional restriction of the axial skeleton are typical symptoms of this condition, which may also be associated with sleep disturbances. Under the age of 40 years, males are the most likely to be affected by the disease (1)(2)(3). AS has a strong genetic component closely linked to the human leukocyte antigen B27 (4).…”

Coexistence of Aortic Pseudocoarctation and Mitral Valve Perforation in a Patient With Takayasu’s Arteritis: Coincidence or Association?

“…Takayasu's arteritis (TA) is a rare, systemic, inflammatory large-vessel vasculitis of unknown etiology that most commonly affects females of childbearing age and causes narrowing and aneurysmal formation of the aorta as well as aortic regurgitation. [1][2][3] However, concomitant stenosis and dilatation of aorta, and anterior mitral leaflet perforation leading to moderate regurgitation is very rare with TA. In this article, we report a case of TA, which is associated or coincidental with other comorbidities.…”