Takayasu’s arteritis mimicking Kawasaki disease in 7-month-old infant, successfully treated with glucocorticosteroids and intravenous immunoglobulins
Takayasu’s arteritis (TA) rarely occurs in infants. There are only four reports on TA in children below 1 year of age, revealing diversity of its symptoms. We describe a 7-month-old female infant hospitalized for hectic fever, irritability, high acute phase indices, and coronary artery dilatations f...
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Veröffentlicht in: | Rheumatology international 2012-11, Vol.32 (11), p.3655-3659 |
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creator | Kierzkowska, Beata Lipińska, Joanna Barańska, Dobromiła Niewiadomska-Jarosik, Katarzyna Biernacka-Zielińska, Małgorzata Stańczyk, Jerzy Smolewska, Elżbieta |
description | Takayasu’s arteritis (TA) rarely occurs in infants. There are only four reports on TA in children below 1 year of age, revealing diversity of its symptoms. We describe a 7-month-old female infant hospitalized for hectic fever, irritability, high acute phase indices, and coronary artery dilatations found on echocardiography, which suggested Kawasaki disease (KD). Despite of standard treatment, rapid development of thoracic and abdominal aorta aneurysms occurred, while coronary artery abnormalities regressed. The initial diagnosis was changed for TA. Subsequently implemented glucocorticosteroids led to clinical and laboratory normalization. However, 2 months after treatment discontinuation, TA relapsed. Glucocorticosteroid therapy was restarted with additional introduction of intravenous immunoglobulins (IVIG), resulting in full and stable remission lasting over 1 year. Thus, diagnosis and treatment of infant TA pose a big challenge to physicians. TA onset in infants may mimics KD. Prolonged glucocorticosteroids and IVIG administration can be recommended in the youngest patients with TA. |
doi_str_mv | 10.1007/s00296-010-1518-y |
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There are only four reports on TA in children below 1 year of age, revealing diversity of its symptoms. We describe a 7-month-old female infant hospitalized for hectic fever, irritability, high acute phase indices, and coronary artery dilatations found on echocardiography, which suggested Kawasaki disease (KD). Despite of standard treatment, rapid development of thoracic and abdominal aorta aneurysms occurred, while coronary artery abnormalities regressed. The initial diagnosis was changed for TA. Subsequently implemented glucocorticosteroids led to clinical and laboratory normalization. However, 2 months after treatment discontinuation, TA relapsed. Glucocorticosteroid therapy was restarted with additional introduction of intravenous immunoglobulins (IVIG), resulting in full and stable remission lasting over 1 year. Thus, diagnosis and treatment of infant TA pose a big challenge to physicians. TA onset in infants may mimics KD. Prolonged glucocorticosteroids and IVIG administration can be recommended in the youngest patients with TA.</description><identifier>ISSN: 0172-8172</identifier><identifier>EISSN: 1437-160X</identifier><identifier>DOI: 10.1007/s00296-010-1518-y</identifier><identifier>PMID: 20473497</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Case Report ; Diagnosis, Differential ; Female ; Glucocorticoids - therapeutic use ; Humans ; Immunoglobulins, Intravenous - therapeutic use ; Infant ; Medicine ; Medicine & Public Health ; Mucocutaneous Lymph Node Syndrome - diagnosis ; Rheumatology ; Takayasu Arteritis - diagnosis ; Takayasu Arteritis - drug therapy ; Treatment Outcome</subject><ispartof>Rheumatology international, 2012-11, Vol.32 (11), p.3655-3659</ispartof><rights>Springer-Verlag 2010</rights><rights>Springer-Verlag Berlin Heidelberg 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-f72ee0c6d93f4407ef06c36489f58c7307a077b226b3d89cfaa37f7deebab9703</citedby><cites>FETCH-LOGICAL-c372t-f72ee0c6d93f4407ef06c36489f58c7307a077b226b3d89cfaa37f7deebab9703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00296-010-1518-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00296-010-1518-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20473497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kierzkowska, Beata</creatorcontrib><creatorcontrib>Lipińska, Joanna</creatorcontrib><creatorcontrib>Barańska, Dobromiła</creatorcontrib><creatorcontrib>Niewiadomska-Jarosik, Katarzyna</creatorcontrib><creatorcontrib>Biernacka-Zielińska, Małgorzata</creatorcontrib><creatorcontrib>Stańczyk, Jerzy</creatorcontrib><creatorcontrib>Smolewska, Elżbieta</creatorcontrib><title>Takayasu’s arteritis mimicking Kawasaki disease in 7-month-old infant, successfully treated with glucocorticosteroids and intravenous immunoglobulins</title><title>Rheumatology international</title><addtitle>Rheumatol Int</addtitle><addtitle>Rheumatol Int</addtitle><description>Takayasu’s arteritis (TA) rarely occurs in infants. There are only four reports on TA in children below 1 year of age, revealing diversity of its symptoms. We describe a 7-month-old female infant hospitalized for hectic fever, irritability, high acute phase indices, and coronary artery dilatations found on echocardiography, which suggested Kawasaki disease (KD). Despite of standard treatment, rapid development of thoracic and abdominal aorta aneurysms occurred, while coronary artery abnormalities regressed. The initial diagnosis was changed for TA. Subsequently implemented glucocorticosteroids led to clinical and laboratory normalization. However, 2 months after treatment discontinuation, TA relapsed. Glucocorticosteroid therapy was restarted with additional introduction of intravenous immunoglobulins (IVIG), resulting in full and stable remission lasting over 1 year. Thus, diagnosis and treatment of infant TA pose a big challenge to physicians. TA onset in infants may mimics KD. Prolonged glucocorticosteroids and IVIG administration can be recommended in the youngest patients with TA.</description><subject>Case Report</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Immunoglobulins, Intravenous - therapeutic use</subject><subject>Infant</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mucocutaneous Lymph Node Syndrome - diagnosis</subject><subject>Rheumatology</subject><subject>Takayasu Arteritis - diagnosis</subject><subject>Takayasu Arteritis - drug therapy</subject><subject>Treatment Outcome</subject><issn>0172-8172</issn><issn>1437-160X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc9qFTEUxoMo9rb6AG4k4MaF0ZNkOplZSvEfFtxUcDdkMsltemeSmpNYZudbiK_XJzGXW0UENwmH8_u-78BHyBMOLzmAeoUAom8ZcGD8lHdsvUc2vJGK8Ra-3Ccb4Eqwrj5H5BjxCurctvCQHAlolGx6tSE_LvROrxrL7fefSHXKNvnskS5-8Wbnw5Z-1Dca9c7TyaPVaKkPVLElhnzJ4jzV0emQX1AsxlhEV-Z5pTlZne1Eb3y-pNu5mGhiyt5ErAHRTzUq7KU56W82xILUL0sJcTvHscw-4CPywOkZ7eO7_4R8fvvm4uw9O__07sPZ63NmpBKZOSWsBdNOvXRNA8o6aI1sm653p51REpQGpUYh2lFOXW-c1lI5NVk76rFXIE_I84PvdYpfi8U8LB6NnWcdbD1r4EKAbDsheEWf_YNexZJCvW7gvHq1vOddpfiBMikiJuuG6-QXndaBw7BvbTi0NsB-rq0Na9U8vXMu42KnP4rfNVVAHACsq7C16a_o_7r-Ap5WqD0</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>Kierzkowska, Beata</creator><creator>Lipińska, Joanna</creator><creator>Barańska, Dobromiła</creator><creator>Niewiadomska-Jarosik, Katarzyna</creator><creator>Biernacka-Zielińska, Małgorzata</creator><creator>Stańczyk, Jerzy</creator><creator>Smolewska, Elżbieta</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20121101</creationdate><title>Takayasu’s arteritis mimicking Kawasaki disease in 7-month-old infant, successfully treated with glucocorticosteroids and intravenous immunoglobulins</title><author>Kierzkowska, Beata ; Lipińska, Joanna ; Barańska, Dobromiła ; Niewiadomska-Jarosik, Katarzyna ; Biernacka-Zielińska, Małgorzata ; Stańczyk, Jerzy ; Smolewska, Elżbieta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-f72ee0c6d93f4407ef06c36489f58c7307a077b226b3d89cfaa37f7deebab9703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Case Report</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Humans</topic><topic>Immunoglobulins, Intravenous - therapeutic use</topic><topic>Infant</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mucocutaneous Lymph Node Syndrome - diagnosis</topic><topic>Rheumatology</topic><topic>Takayasu Arteritis - diagnosis</topic><topic>Takayasu Arteritis - drug therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kierzkowska, Beata</creatorcontrib><creatorcontrib>Lipińska, Joanna</creatorcontrib><creatorcontrib>Barańska, Dobromiła</creatorcontrib><creatorcontrib>Niewiadomska-Jarosik, Katarzyna</creatorcontrib><creatorcontrib>Biernacka-Zielińska, Małgorzata</creatorcontrib><creatorcontrib>Stańczyk, Jerzy</creatorcontrib><creatorcontrib>Smolewska, Elżbieta</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Rheumatology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kierzkowska, Beata</au><au>Lipińska, Joanna</au><au>Barańska, Dobromiła</au><au>Niewiadomska-Jarosik, Katarzyna</au><au>Biernacka-Zielińska, Małgorzata</au><au>Stańczyk, Jerzy</au><au>Smolewska, Elżbieta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Takayasu’s arteritis mimicking Kawasaki disease in 7-month-old infant, successfully treated with glucocorticosteroids and intravenous immunoglobulins</atitle><jtitle>Rheumatology international</jtitle><stitle>Rheumatol Int</stitle><addtitle>Rheumatol Int</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>32</volume><issue>11</issue><spage>3655</spage><epage>3659</epage><pages>3655-3659</pages><issn>0172-8172</issn><eissn>1437-160X</eissn><abstract>Takayasu’s arteritis (TA) rarely occurs in infants. There are only four reports on TA in children below 1 year of age, revealing diversity of its symptoms. We describe a 7-month-old female infant hospitalized for hectic fever, irritability, high acute phase indices, and coronary artery dilatations found on echocardiography, which suggested Kawasaki disease (KD). Despite of standard treatment, rapid development of thoracic and abdominal aorta aneurysms occurred, while coronary artery abnormalities regressed. The initial diagnosis was changed for TA. Subsequently implemented glucocorticosteroids led to clinical and laboratory normalization. However, 2 months after treatment discontinuation, TA relapsed. Glucocorticosteroid therapy was restarted with additional introduction of intravenous immunoglobulins (IVIG), resulting in full and stable remission lasting over 1 year. Thus, diagnosis and treatment of infant TA pose a big challenge to physicians. TA onset in infants may mimics KD. Prolonged glucocorticosteroids and IVIG administration can be recommended in the youngest patients with TA.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>20473497</pmid><doi>10.1007/s00296-010-1518-y</doi><tpages>5</tpages></addata></record> |
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subjects | Case Report Diagnosis, Differential Female Glucocorticoids - therapeutic use Humans Immunoglobulins, Intravenous - therapeutic use Infant Medicine Medicine & Public Health Mucocutaneous Lymph Node Syndrome - diagnosis Rheumatology Takayasu Arteritis - diagnosis Takayasu Arteritis - drug therapy Treatment Outcome |
title | Takayasu’s arteritis mimicking Kawasaki disease in 7-month-old infant, successfully treated with glucocorticosteroids and intravenous immunoglobulins |
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