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Tuberculosis and Takayasu arteritis: case-based review

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Abstract

This report presents a case of co-occurrence of Takayasu arteritis (TA) and multiorgan tuberculosis (TB) in a 20-year-old female and provides a review of 18 previously reported cases of co-occurring TA and TB. All patients were between 9 and 24 years of age. Most reports describe a concomitant diagnosis of active TB and TA. TB lymphadenitis was described in 11 cases (57.9%), and microbiologically confirmed in 4 of these. All patients received antituberculous therapy and most received corticosteroids (89.5%). In our and two other cases, TA relapses necessitating additional immunosuppressive therapy were observed.

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References

  1. WHO (2018) Global Tuberculosis Report

  2. Brunner J, Feldman BM, Tyrrell PN, Kuemmerle-Deschner JB, Zimmerhackl LB, Gassner I, Benseler SM (2010) Takayasu arteritis in children and adolescents. Rheumatology 49:1806–1814. https://doi.org/10.1093/rheumatology/keq167

    Article  PubMed  Google Scholar 

  3. Li J, Zhu M, Li M, Zheng W, Zhao J, Tian X, Zeng X (2016) Cause of death in Chinese Takayasu arteritis patients. Medecine 95:e4069. https://doi.org/10.1097/MD.0000000000004069

    Article  Google Scholar 

  4. Serra R, Butrico L, Fugetto F, Chibireva MD, Malva A, De Caridi G, Massara M, Barbetta A, Cannistrà M, de Franciscis S (2016) Updates in pathophysiology, diagnosis and management of Takayasu arteritis. Ann Vasc Surg 35:210–225. https://doi.org/10.1016/j.avsg.2016.02.011

    Article  PubMed  Google Scholar 

  5. Saruhan-Direskeneli G, Hughes T, Aksu K, Keser G, Coit P, Aydin SZ, Alibaz-Oner F, Kamali S, Inanc M, Carette S, Hoffman GS, Akar S, Onen F, Akkoc N, Khalidi NA, Koening C, Karadag O, Kiraz S, Langford CA, McAlear CA, Ozbalkan Z, Ates A, Karaaslan Y, Maksimowicz-Mckinnon K, Monach PA, Ozer HT, Seyahi E, Fresko I, Cefle A, Seo P, Warrington KJ, Ozturk MA, Ytterberg SR, Cobankara V, Onat AM, Guthridge JM, James JA, Tunc E, Duzgun N, Bicakcigil M, Yentür SP, Merkel PA, Direskeneli H, Sawalha AH (2013) Identification of multiple genetic susceptibility loci in Takayasu arteritis. Am J Hum Genet 93:298–305. https://doi.org/10.1016/j.ajhg.2013.05.026

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Soto ME, Del Carmen Ávila-Casado M, Huesca-Gómez C, Alarcon GV, Castrejon V, Soto V, Hernandez S, Espinola-Zavaleta N, Vallejo M, Reyes PA, Gamboa R (2012) Detection of IS6110 and HupB gene sequences of Mycobacterium tuberculosis and bovis in the aortic tissue of patients with Takayasu’s arteritis. BMC Infect Dis 12:194. https://doi.org/10.1186/1471-2334-12-194

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Barra L, Kanji T, Malette J, Pagnoux C, CanVasc (2018) Imaging modalities for the diagnosis and disease activity assessment of Takayasu’s arteritis: a systematic review and meta-analysis. Autoimmun Rev 17:175–187. https://doi.org/10.1016/j.autrev.2017.11.021

    Article  PubMed  Google Scholar 

  8. Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lie JT, Lightfoot RW (1990) The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 33:1129–1134

    Article  CAS  PubMed  Google Scholar 

  9. Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, Buoncompagni A, Lazar C, Bilge I, Uziel Y, Rigante D, Cantarini L, Hilario MO, Silva CA, Alegria M, Norambuena X, Belot A, Berkun Y, Estrella AI, Olivieri AN, Alpigiani MG, Rumba I, Sztajnbok F, Tambic-Bukovac L, Breda L, Al-Mayouf S, Mihaylova D, Chasnyk V, Sengler C, Klein-Gitelman M, Djeddi D, Nuno L, Pruunsild C, Brunner J, Kondi A, Pagava K, Pederzoli S, Martini A, Ruperto N, Paediatric Rheumatology International Trials Organisation (PRINTO) (2010) EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: final classification criteria. Ann Rheum Dis 69:798–806. https://doi.org/10.1136/ard.2009.116657

    Article  PubMed  Google Scholar 

  10. Hata A, Noda M, Moriwaki R, Numano F (1996) Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol 54(Suppl):S155–S163

    Article  PubMed  Google Scholar 

  11. Almohammadi AA, Consunji-Araneta R (2007) Two cases of Takayasu’s arteritis and tuberculosis. Chest 132:675A. https://doi.org/10.1378/chest.132.4_MeetingAbstracts.675a

    Article  Google Scholar 

  12. Pantell RH, Goodman BW (1981) Takayasu’s arteritis: the relationship with tuberculosis. Pediatrics 67:84–88

    CAS  PubMed  Google Scholar 

  13. Modi G, Modi M (2000) Cold agglutinins and cryoglobulins in a patient with acute aortoarteritis (Takayasu’s disease) and tuberculous lymphadenitis. Rheumatology 39:337–338

    Article  CAS  PubMed  Google Scholar 

  14. Yang M-C, Yang C-C, Chen C-A, Wang J-K (2013) Takayasu arteritis presenting with acute heart failure. J Am Coll Cardiol 61:1302. https://doi.org/10.1016/j.jacc.2012.09.070

    Article  PubMed  Google Scholar 

  15. Al-Aghbari K, Al-Motarreb A, Askar F (2010) Takayasu’s arteritis associated with tuberculosis in a young Yemeni woman. Heart Views 11:117–120. https://doi.org/10.4103/1995-705X.76804

    Article  PubMed  PubMed Central  Google Scholar 

  16. Baijal R, Chogle A, Kumar P, Shah N, Kulkarni S, Doshi S, Gupta D, Amarapurkar D (2015) A case of tuberculous colitis with associated Takayasu’s arteritis. J Assoc Physicians India 63:62–65

    PubMed  Google Scholar 

  17. Moura C, Aquino MA, Rocha Filho J, Santiago M (2015) Takayasu’s or tuberculous arteritis? BMJ Case Rep. https://doi.org/10.1136/bcr-2014-208717

    Article  PubMed  PubMed Central  Google Scholar 

  18. Khemiri M, Douira W, Barsaoui S (2016) Co-occurrence of Takayasu′s arteritis and tuberculosis: Report of a Tunisian pediatric case. Ann Pediatr Cardiol 9:75–78. https://doi.org/10.4103/0974-2069.171398

    Article  PubMed  PubMed Central  Google Scholar 

  19. Walters HM, Aguiar CL, MacDermott EJ, Adams A, Barinstein L, Dayton JD, Salvatore C, Thimmappa N, Lehman TJ (2013) Takayasu arteritis presenting in the context of active tuberculosis. J Clin Rheumatol 19:344–347. https://doi.org/10.1097/RHU.0b013e31829ce750

    Article  PubMed  Google Scholar 

  20. Duzova A, Türkmen O, Cinar A, Cekirge S, Saatci U, Ozen S (2000) Takayasu’s arteritis and tuberculosis: a case report. Clin Rheumatol 19:486–489

    Article  CAS  PubMed  Google Scholar 

  21. Kontogiannis V, Dalziel KL, Powell RJ (2000) Papulonecrotic tuberculide and stenosis of the abdominal aorta. Rheumatology 39:205–208

    Article  CAS  PubMed  Google Scholar 

  22. Zaki S, Shanbag P, Chavan V (2011) Unusual presentation of Takayasu′s arteritis as posterior reversible encephalopathy syndrome. Ann Indian Acad Neurol 14:214. https://doi.org/10.4103/0972-2327.85900

    Article  PubMed  PubMed Central  Google Scholar 

  23. Mukherjee D, Niyogi P (2013) Active tuberculosis with Takayasu arteritis. Indian Pediatr 50:349–350

    Article  PubMed  Google Scholar 

  24. Wensing G, Kirch W, Ohnhaus EE (1987) Patientin mit Takayasu-arteritis und protein C- sowie AT III-Mangel. Klin Wochenschr 65:752–756. https://doi.org/10.1007/BF01736813

    Article  CAS  PubMed  Google Scholar 

  25. Sivashanmugam S, Gopalan V, Radhakrishnan AR, Sukumar P, Baskar N, Radhakrishnan N, Prasad PV, Ramamurthy A (1981) Tuberculous aorto-arteritis. A case report. Indian Heart J 33:73–77

    CAS  PubMed  Google Scholar 

  26. Ahasan HAMN, Alam B, Chowdhury MH, Mohammed FR, Nur Z (2009) Takayasu’s arteritis in association with tuberculosis in a young woman. Pak J Med Sci 25:1009–1011

    Google Scholar 

  27. Reshkova V, Kalinova D, Rashkov R (2016) Takayasu’s arteritis associated with tuberculosis infections. J Neurol Neurosci 7:114. https://doi.org/10.21767/2171-6625.1000114

    Article  Google Scholar 

  28. Minozzi S, Bonovas S, Lytras T, Pecoraro V, González-Lorenzo M, Bastiampillai AJ, Gabrielli EM, Lonati AC, Moja L, Cinquini M, Marino V, Matucci A, Milano GM, Tocci G, Scarpa R, Goletti D, Cantini F (2016) Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis. Expert Opin Drug Saf 15:11–34. https://doi.org/10.1080/14740338.2016.1240783

    Article  CAS  PubMed  Google Scholar 

  29. Lim AY, Lee GY, Jang SY, Gwag HB, Choi SH, Jeon E-S, Cha H-S, Sung K, Kim Y-W, Kim SM, Choe YH, Koh W-J, Kim D-K (2016) Comparison of clinical characteristics in patients with Takayasu arteritis with and without concomitant tuberculosis. Heart Vessels 31:1277–1284. https://doi.org/10.1007/s00380-015-0731-8

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  31. Handa U, Mundi I, Mohan S (2012) Nodal tuberculosis revisited: a review. J Infect Dev Ctries 6:6–12

    Article  PubMed  Google Scholar 

  32. Jain A, Misra DP, Ramesh A, Basu D, Jain VK, Negi VS (2017) Tuberculosis mimicking primary systemic vasculitis: not to be missed! Trop Doct 47:158–164. https://doi.org/10.1177/0049475516687432

    Article  PubMed  Google Scholar 

  33. Gornik HL, Creager MA (2008) Aortitis. Circulation 117:3039–3051. https://doi.org/10.1161/CIRCULATIONAHA.107.760686

    Article  PubMed  PubMed Central  Google Scholar 

  34. Arnaud L, Cambau E, Brocheriou I, Koskas F, Kieffer E, Piette J-C, Amoura Z (2009) Absence of Mycobacterium tuberculosis in arterial lesions from patients with Takayasu’s arteritis. J Rheumatol 36:1682–1685. https://doi.org/10.3899/jrheum.080953

    Article  PubMed  Google Scholar 

  35. Aggarwal A, Chag M, Sinha N, Naik S (1996) Takayasu’s arteritis: role of Mycobacterium tuberculosis and its 65 kDa heat shock protein. Int J Cardiol 55:49–55

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Tropical Medicine and Infectious Diseases, Rostock University Medical Center, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany

    Moritz K. Jansson, Hilte F. Geerdes-Fenge & Emil C. Reisinger

  2. Department of Medicine, Rheumatology and Clinical Immunology, Klinikum Südstadt, Rostock, Südring 81, 18059, Rostock, Germany

    Antje Kangowski & Christian Kneitz

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  1. Moritz K. Jansson
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  2. Hilte F. Geerdes-Fenge
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Contributions

MKJ: writing of manuscript including editing and revision and the literature review at all stages of its production, clinical management of patient. HFG-F: writing of manuscript including editing and revision and the literature review at all stages of its production, clinical management of patient. AK/CK: clinical management of patient, contributions to editing and revision. ECR: manuscript editing and revision at all stages of production, final approval of manuscript, clinical management of patient.

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Correspondence to Moritz K. Jansson.

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A written informed consent was signed by the patient in case concerning publication of this case report. A copy of this consent is available for editors of this journal.

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Jansson, M.K., Geerdes-Fenge, H.F., Kangowski, A. et al. Tuberculosis and Takayasu arteritis: case-based review. Rheumatol Int 39, 345–351 (2019). https://doi.org/10.1007/s00296-018-4231-x

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  • DOI: https://doi.org/10.1007/s00296-018-4231-x

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