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An elderly female who survived more than 30 years following a diagnosis of Takayasu’s arteritis, complicated by fatal intestinal amyloidosis

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Abstract

Compared to young patients with Takayasu’s arteritis (TA), little information about elderly patients with TA has been reported. Additionally, no reports were found regarding TA cases with complications of intestinal amyloidosis. This is a case report of an elderly female, who developed intestinal amyloidosis, during late-stage TA. After years of outpatient management, she developed sudden severe dyspnea with pulmonary effusion, requiring hospitalization. After this event, betamethasone was replaced by methotrexate (MTX) for the next 34 months, but it seemed ineffective. After 1.5 years, she developed intractable diarrhea, followed by increases in BUN and serum creatinine (Cr), requiring several courses of hemodialysis. Colonoscopy revealed the presence of amyloid in her intestine, although she died of complicated sepsis caused by MRSA infection. This may be the first paper describing intestinal amyloidosis in a TA patient. Additionally, her case is rare in that she lived more than 30 years after the onset and diagnosis of TA.

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Abbreviations

ANA:

Antinuclear antibody

AR:

Aortic regurgitation

BUN:

Blood urea nitrogen

Ccr:

Creatinine clearance

Cr:

Creatinine

CRP:

C-reactive protein

ERS:

Erythrocyte sedimentation rate

HOT:

Home oxygen treatment

IA and IV-DSA:

Intraarterial and intravenous digital subtraction angiography

LVH:

Left ventricular hypertrophy

MR:

Mitral regurgitation

MRSA:

Methicillin-resistant Staphyloccus aureus

MTX:

Methotrexate

TA:

Takayasu’s arteritis

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Acknowledgements

We gratefully acknowledge Cheryl L. Brandi, DNSc, RN, College of Nursing, and Hiroaki Ando, PhD, Information Processing Center, Aichi Medical University, Japan, for their assistance with this manuscript.

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Authors and Affiliations

  1. Section of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Medical Clinic (part-time), Higashi Sakura 2-12-1, Higashi-ku, Nagoya, 461-0005, Japan

    S. Nakamura

  2. Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Aichi Medical University School of Medicine, Karimata Nagakute, Aichi-ken, 490-1195, Japan

    M. Morishita

  3. Department of Internal Medicine, Division of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Karimata Nagakute, Aichi-ken, 490-1195, Japan

    C. L. Yang

  4. Department of Internal Medicine, Division of Gastroenterology, Aichi Medical University School of Medicine, Karimata Nagakute, Aichi-ken, 490-1195, Japan

    K. Utsumi

  5. Department of Internal Medicine, Kasugai Municipal Hospital, Takagi-cho, 1-1-1, Aichi-ken, 486-8510, Japan

    H. Takada

  6. Department of Gastroenterology, Kasugai Municipal Hospital, Takagi-cho, 1-1-1, Aichi-ken, 486-8510, Japan

    K. Furuhashi

  7. Clinical Laboratory, Kasugai Municipal Hospital, Takagi-cho, 1-1-1, Aichi-ken, 486-8510, Japan

    H. Sugiura

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  1. S. Nakamura
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  2. M. Morishita
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  3. C. L. Yang
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  4. K. Utsumi
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  5. H. Takada
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  6. K. Furuhashi
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  7. H. Sugiura
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Correspondence to S. Nakamura.

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Nakamura, S., Morishita, M., Yang, C.L. et al. An elderly female who survived more than 30 years following a diagnosis of Takayasu’s arteritis, complicated by fatal intestinal amyloidosis. Clin Rheumatol 25, 907–910 (2006). https://doi.org/10.1007/s10067-005-0088-y

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  • DOI: https://doi.org/10.1007/s10067-005-0088-y

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