Bilateral ocular ischemia-induced blindness as a presenting manifestation of Takayasu arteritis: A case report

被引：12
作者：
Pallangyo P. [1 ]
Epafra E. [1 ]
Nicholaus P. [1 ]
Lyimo F. [2 ]
Kazahura P. [1 ]
Janabi M. [1 ]
机构：
[1] Department of Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O. Box 65141, Dar es Salaam
[2] Department of Radiology, Muhimbili National Hospital, P.O. Box 65000, Dar es Salaam
来源：
Journal of Medical Case Reports | / 11卷 / 1期
关键词：
Case report; Chronic granulomatous vasculitis; Granulomatous panarteritis; Large vessel vasculitis; Occlusive thromboaortopathy; Pulseless disease; Takayasu arteritis;
D O I：
10.1186/s13256-017-1330-3
中图分类号：
学科分类号：
摘要：
Background: Takayasu arteritis is a granulomatous panarteritis that predominantly affects the aorta and its major branches. The initial manifestations of this large-vessel vasculitis are usually nonspecific; however, as the disease progresses, typical symptoms of arterial occlusion, aneurysmal formation, and vascular pain become evident. Ischemic ocular complications of Takayasu arteritis which could lead to complete loss of vision are not uncommon and depend on the obliterated portion(s) of carotid(s), the intensity and rate of progression of ocular vascular insufficiency, and sufficiency of the collateral blood supply to the eye. Case presentation: A 24-year-old woman of African descent with prior normal vision was referred to us with a 3-year history of gradual decline in visual acuity in both eyes and unintentional weight loss (17 kg) within the past 1 year. A physical examination revealed feeble brachial and radial arterial pulses on her left side. She had sinus tachycardia (136 beats/minute) and her blood pressure was 85/59 mmHg on her left and 134/82 mmHg on her right side. Bilateral microaneurysms, dot and blot hemorrhages, and multiple ischemic areas of retina together with neovascularization in her right eye were noted during a funduscopic examination. Computed tomography angiography of her thoracic and abdominal aorta revealed irregular narrowing with variable degrees of stenosis, tapering, and corrugated appearance. Conclusions: Despite its rarity, Takayasu arteritis significantly impairs a patient's quality of life and has a life-threatening potential. Early initiation of appropriate therapy could delay disease progression and reduce the associated complications. © 2017 The Author(s).
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