Abstract
Takayasu’s arteritis (TA) is a rare large vessel vasculitis that is difficult to diagnose in the early stages. Therefore, it is also very difficult to manage and prevent irreversible vascular damage in TA. A 19-year-old female patient with back pain was examined using [18F]-FDG-PET to detect the source of inflammation. Specific accumulation of [18F]-FDG was observed in the thoracic and abdominal aorta, leading to the diagnosis of TA. Corticosteroid treatment resulted in clinical remission. However, the serum amyloid A (SAA) levels remained elevated. A follow-up scan showed residual uptake of [18F]-FDG in the thoracic aorta suggesting subclinical vascular inflammation. Methotrexate was combined with the corticosteroid, and the elevated levels of SAA became normalized. The present case suggests that monitoring serum levels of SAA and [18F]-FDG-PET could help clinicians to make adequate treatment adjustments in TA patients.
This is a preview of subscription content, log in via an institution to check access.
References
Weyand CM, Goronzy JJ (2003) Medium- and large-vessel vasculitis. N Engl J Med 349:160–169
Vanoli M, Daina E, Salvarani C, Sabbadini MG, Rossi C, Bacchiani G, Schieppati A, Baldissera E, Bertolini G, Group ItakaStudy (2005) Takayasu’s arteritis: a study of 104 Italian patients. Arthritis Rheum 53:100–107
Ogino H, Matsuda H, Minatoya K, Sasaki H, Tanaka H, Matsumura Y, Ishibashi-Ueda H, Kobayashi J, Yagihara T, Kitamura S (2008) Overview of late outcome of medical and surgical treatment for Takayasu arteritis. Circulation 118:2738–2747
Borg FA, Dasgupta B (2009) Treatment and outcomes of large vessel arteritis. Best Pract Res Clin Rheumatol 23:325–337
Andrews J, Mason JC (2007) Takayasu’s arteritis: recent advances in imaging offer promise. Rheumatology 46:6–15
Salvarani C, Cantini F, Boiardi L, Hunder GG (2003) Laboratory investigations useful in giant cell arteritis and Takayasu’s arteritis. Clin Exp Rheumatol 21:S23–S28
Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, Hoffman GS (1994) Takayasu arteritis. Ann Intern Med 120:919–929
Gabay C, Kushner I (1999) Acute phase proteins and other systemic responses to inflammation. N Engl J Med 340:448–454
Cunnane G, Grehan S, Geoghegan S, McCormack C, Shields D, Whitehead AS, Bresnihan B, Fitzgerald O (2000) Serum amyloid A in the assessment of early inflammatory arthritis. J Rheumatol 27:58–63
Malle E, De Beer FC (1996) Human serum amyloid A (SAA) protein: a prominent acute-phase reactant for clinical practice. Eur J Clin Invest 26:427–435
Park MC, Lee SW, Park YB, Lee SK (2006) Serum cytokine profiles and their correlations with disease activity in Takayasu’s arteritis. Rheumatology (Oxford) 45(5):545–548
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Koga, T., Nishino, Y., Makiyama, J. et al. Serum amyloid A is a useful marker to evaluate the disease activity of Takayasu’s arteritis. Rheumatol Int 30, 561–563 (2010). https://doi.org/10.1007/s00296-009-1296-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-009-1296-6