神経学および神経科学ジャーナル

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Takayasu's Arteritis associated with Tuberculosis Infections

Reshkova V, Kalinova D and Rashkov R

Takayasu’s arteritis (TA) is an inflammatory disease of unknown etiology characterized by granulomatous vasculitis affecting the aorta, its main branches and the pulmonary arteries. It occurs most often in women of child-bearing age. At the time of diagnosis 10% to 20% of patients with TA are clinically asymptomatic. The remaining 80% to 90% of patients present with systemic or vascular symptoms. The most important points in diagnosing Takayasu’s arteritis are the clinical features, physical examination and diagnostic imaging (catheterdirected dye arteriography, magnetic resonance angiography, computed tomographic angiography). The etiology of TA is not clear. A possible relationship between TA and tuberculosis has been suggested. Some studies suggest cross-reaction between Mycobacterium tuberculosis and human heat shock protein. It has been speculated the role of mycobacterial super antigens, which cause polyclonal T cell activation and massive cytokine release, that induce vascular damage. The use of tuberculostatic drugs is rationale during the treatment of TA. We report two interesting clinical cases of Takayasu’s arteritis and tuberculosis. The first clinical case presents a rare case of TA and tuberculous lymphadenitis in an 18 year old male patient. The second case presented TA associated with latent tuberculosis in a 36 year old man.