Co-existing sarcoidosis and Takayasu arteritis: report of a case

Abstract

IntroductionTakayasu arteritis (TA) is a chronic vasculitis of unknown origin, affecting mainly the aorta and its main branches. As a result of the inflammation, stenosis, occlusion or dilatation of the involved vessels may occur and cause a wide range of symptoms. It has been described in association with various auto-immune disorders (mainly inflammatory digestive tract diseases). However, only few cases of TA associated with sarcoidosis have been reported, raising the question of an association by chance.Case reportWe report a case of a 34 year-old woman, with one year history of sarcoidosis, who presented with asymmetric high hypertension revealing inflammatory humeral, axillary and subclavian arteritis related to TA, successfully treated by steroid and immunosuppressive therapy(MethotrexateR).ConclusionTA and sarcoidosis may be related, rising the hypothesis that TA or Takayasu arteritis-like granulomatous vasculitis may be, in fact, a complication of sarcoidosis.

Sarcoidosis with Takayasu arteritis: a model of overlapping granulomatosis. A report of seven cases and literature review

“…Sarcoidosis is very rarely reported as associated with vasculitis, such as giant cell arteritis or granulomatosis with polyangiitis . Less than 15 cases of TA plus sarcoidosis have been described in the literature (Table ), mostly observed in women (77%) as in our series. We noted that sarcoidosis generally precedes TA as in the series by Weiler et al .…”

“…Reported cases of vasculitis in patients presenting with sarcoidosis are exceptional. Few cases of sarcoidosis together with granulomatous vasculitis such as Takayasu or Takayasu‐like large vessel vasculitis have been described . Interestingly, in both diseases pro‐inflammatory cytokines and among these, tumor necrosis factor alpha are increased and play a pathogenic role in the development of the disease.…”

Takayasu Arteritis and Ulcerative Cutaneous Sarcoidosis

“…Various types of skins lesion associated with sarcoidosis have been reported, and ulcerative lesion formation, although rare, represents one of many atypical presentations (2). Several recent case reports have described the coexistence of Takayasu arteritis and immune-related disorders, including sarcoidosis (3). In this report, we describe the case of a patient with Takayasu arteritis who presented with refractory ulcerative skin lesions of the lower extremities initially caused by limb ischemia due to occlusion of the peripheral arteries; these lesions were eventually diagnosed histologically as necrotizing granulomas of cutaneous sarcoidosis.…”

A case of Takayasu's arteritis with endobronchial involvement

“…Akciğer tutulumuna olguların %50'sinde rastlanmakta olup, bu tutulum sınırlı formdan yaygın olan forma kadar değişkenlik gösterir. Sıklıkla pulmoner arter düzeyinde tutulumun olduğu TA'da, hastalığın parankim tutulumuyla seyrettiği olgular nadir olup, bildirilen olgularda radyolojik olarak bronşektazi, konsolidasyon, interstisyel akciğer fibrozisi ile uyumlu lezyonlar gösterilmiştir (3)(4)(5). Bizim olgumuzun ilginç olan yanı ise akciğer semptomlarıyla başlayan hastalığın radyolojisinde pulmoner arter ve parankimde patolojik bulgu olmaması ve yapılan bronkoskopik değerlendirmeyle endobronşi-yal lezyonların gösterilmiş olmasıdır.…”

“…TA'nın, sarkoidoz ve inflamatuvar bağırsak hastalıkları gibi çeşitli otoimmün hastalıklarla birlikteliğini gösteren çok sayıda yayın bulunmaktadır (3,4). Ateş, öksürük, kilo kaybı, iştahsızlık gibi nonspesifik yakınmalarla başla-yabilmesi nedeniyle birçok hastalıkla karışır ve tanıda gecikmeler görülür.…”