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Portal hypertension: an uncommon clinical manifestation of Takayasu arteritis in a 9-year-old child

Authors Herrera CN, Tomala-Haz JE

Received 9 June 2016

Accepted for publication 2 August 2016

Published 15 November 2016 Volume 2016:8 Pages 115—118


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Chuan-Ju Liu

Cristina N Herrera, Javier E Tomala-Haz

Department of Pediatric Rheumatology, Dr Roberto Gilbert Children’s Hospital, Guayaquil, Ecuador

Abstract: Takayasu arteritis (TA) is the third most common childhood vasculitis and its clinical manifestations depend on the arteries involved. We report a case of a 9-year-old boy with multiple aneurysms in carotid and iliac arteries, subclavian and coronary arteries, and abdominal aorta. At the age of 7 years, he presented with recurrent fever and hepatosplenomegaly. An angio-computed tomography scan showed aneurysms in the left subclavian artery, abdominal aorta, and both proximal iliac arteries. He was diagnosed with TA and was treated with corticosteroids, aspirin, and enalapril. One year later, he was admitted to Dr Roberto Gilbert Children’s Hospital because of intracranial hemorrhage. Angiography revealed enlargement of aneurysms enlargement and new aneurysms. He also developed portal hypertension. Treatment with intravenous corticosteroids, azathioprine, and monthly intravenous cyclophosphamide was begun. After 6 months of no improvement, infliximab was begun. The aim of this article was to report the concurrence of coronary involvement and portal vein hypertension in pediatric TA because there were scarce reports on this matter.

Keywords: Takayasu arteritis, coronary aneurysm, children, portal hypertension

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