1/24. A case of aortitis syndrome and IgA nephropathy: possible role of human leukocyte antigens in both diseases.A 51-year-old woman, who had both aortitis syndrome (takayasu arteritis) and IgA nephropathy, presented with hypertension, fever, a high erythrocyte sedimentation rate, high c-reactive protein and serum IgG levels, proteinuria, and renal dysfunction. Renal arteriography showed stenosis and poststenotic dilatation at the origin of the right renal artery, as well as tortuosity of the left renal artery branches and marked atrophy of the left kidney. Renal biopsy showed IgA nephropathy with deposits of IgA, C3, and fibrinogen in the glomeruli and arteriolosclerosis. The present patient had human leukocyte antigen (HLA)-B 52, which is reported to be related to the aortitis syndrome, as well as HLA-DR 4, which is possibly related to IgA nephropathy, suggesting that HLA status may be involved in the pathogenesis of both diseases.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
2/24. Takayasu's arteritis associated with idiopathic ulcerative colitis.Two patients with ulcerative colitis associated with Takayasu's arteritis are described. gangrene of a limb was the presenting feature in one patient and renovascular disease in the other. angiography showed vascular occlusions affecting several medium or large sized vessels in both patients.- - - - - - - - - - ranking = 21.87900625keywords = renovascular (Clic here for more details about this article) |
3/24. Paroxysmal hypertension in aortitis syndrome.Three patients with aortitis syndrome ehibited paroxysmal hypertension which seemed to result from baroreceptor dysfunction. All of the patients had signs of active inflammation of aortitis syndrome and stenotic carotid and subclavian arteries. During the attacks, the blood pressure rose to at least 230 mm. Hg systolic and the heart rate exceeded 100. However, with prolonged administration of steroid hormones, the attacks ceased. In two patients with dilated thoracic aortas and aortic regurgitation, the attacks of paroxysmal hypertension occurred without apparent precipitating factors and were followed by anginal pain with marked ST depression. The sympathicotonic state resulting from the disturbance of the baroreceptors was considered to be responsible for the attacks. In another patient, the attacks occurred in the course of treatment with a steroid hormone and were provoked only by voluntary micturition. This post-micturition hypertension was presumed to be an expression of abnormal overshooting following a fall in blood pressure after voiding.- - - - - - - - - - ranking = 7keywords = hypertension (Clic here for more details about this article) |
4/24. Anaesthetic management for nephrectomy in a child with Takayasu's arteritis and severe renovascular hypertension. A case report.The case of a 3-year-old boy with Takayasu's arteritis and severe renovascular hypertension presenting for nephrectomy is described. Emphasis is laid on control of the hypertension during anaesthesia and careful monitoring of cardiovascular parameters, which may be difficult in the absence of peripheral pulses.- - - - - - - - - - ranking = 115.39503125keywords = renovascular, hypertension (Clic here for more details about this article) |
5/24. Takayasu's disease associated with generalised amyloidosis.A case of Takayasu's disease in a young Caucasian female is described. The major complications which developed over the ten year course of the disease include nephrotic syndrome, severe refractory hypertension, aortic valve regurgitation associated with aneurysmal dilatation of the ascending aorta, and recurrent congestive heart failure. Amyloid deposits have been demonstrated in the aorta, atrial appendage, aortic valve, and renal cortex. The association of amyloidosis and Takayasu's disease is discussed.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
6/24. captopril in the treatment of renovascular hypertension secondary to Takayasu's arteritis. A case report.A case of Takayasu's arteritis complicated by renovascular hypertension is described. The hypertension was refractory to conventional medical treatment but responsive to captopril therapy. Deterioration in renal function occurred on initiation of captopril therapy; this resolved on reduction of dosage. A captopril-induced disturbance of renal autoregulation was probably responsible for this phenomenon.- - - - - - - - - - ranking = 115.39503125keywords = renovascular, hypertension (Clic here for more details about this article) |
7/24. Takayasu's arteritis presenting as pulmonary hypertension.Takayasu's arteritis (pulseless disease) is a vasculitis that affects the large arteries, including the aorta, its branches, and the pulmonary arteries. A 15-year-old girl with Takayasu's arteritis was referred to our institution for marked pulmonary hypertension in the absence of symptoms referable to systemic vasculitis. She was shown to have a thickened, narrowed thoracic aorta, a stenosed right axillary artery, and severely affected pulmonary arteries. Despite corticosteroid therapy she died one month after diagnosis. This patient's illness indicates that pulmonary vessels might be the principal vessels involved in Takayasu's arteritis.- - - - - - - - - - ranking = 5keywords = hypertension (Clic here for more details about this article) |
8/24. Operative treatment of nonspecific aortoarteritis (Takayasu's arteritis).Operative treatment of nonspecific aortoarteritis remains controversial and little information is available on the results of reconstruction of extracranial cerebral vasculature in this disease. Our experience with 25 patients with histologically proven symptomatic disease treated during a 4-year period is presented. The aortic arch and its branches were involved in 12 patients and 13 had disease affecting the descending aorta and its tributaries. patients with cerebrovascular disease had aneurysms, minor stroke, or intermittent neurologic dysfunction. Descending aortic involvement resulted either in symptomatic or ruptured aneurysm and renovascular hypertension. Operative treatment of cerebrovascular disease comprised aortic arch (three patients), carotid (three patients), or subclavian artery reconstruction (six patients). Descending aortic reconstruction comprised thoracoabdominal (four patients) or infrarenal (five patients) aneurysmorrhaphy, abdominal aortic replacement with bilateral renal artery reconstruction (two patients), and nephrectomy (two patients). One early postoperative death occurred because of stroke. Twenty-four survivors have been observed between 3 and 42 months. No deaths or further neurologic episodes have occurred during this period and three of five hypertensive patients were cured. We conclude that symptomatic aortoarteritis, including cerebrovascular disease, may be treated by standard operative techniques with rewarding results.- - - - - - - - - - ranking = 22.87900625keywords = renovascular, hypertension (Clic here for more details about this article) |
9/24. Surgical repair of visceral artery occlusions in Takayasu's disease.We describe the surgical management of six patients with occlusive disease of the visceral arteries caused by Takayasu's arteritis. All patients suffered from renovascular hypertension and, in addition, three of the patients also had symptoms of mesenteric angina. Surgical repair is recommended in the "burn-out" phase of the disease when further progression of the disease is unlikely. Revascularization of the kidneys was by autotransplantation to the iliac vessels. Mesenteric or celiac artery inflow was provided by an extra-anatomic vein bypass graft from the iliac artery. In all cases distal disease-free vessels were available for reconstructive surgery.- - - - - - - - - - ranking = 22.87900625keywords = renovascular, hypertension (Clic here for more details about this article) |
10/24. Surgical treatment of Takayasu's disease.Thirty-nine patients (mean age: 33 years) with Takayasu's disease were observed over the past 8 years. Among these patients, 33 had surgical intervention with a mean follow-up of 4 years. Lesions of the aortic arch were the most common (29 patients, 69 lesions) and frequently were associated with lesions in another site as well. However, in this group of patients, the infrequent presence of signs of cerebral vascular insufficiency limited the number of suitable surgical candidates to 14 patients. Lesions of the renal arteries were noted in 25 patients (37 lesions) and were associated with coarctation of the thoracoabdominal aorta in 12 patients. In contrast to lesions of the aortic arch, the presence of severe hypertension was a frequent indication for surgery in Takayasu's disease. Twenty-one patients had operation. Twenty of 21 patients were considered cured or improved of hypertension. The one patient who received no benefit was the only operative death of the study. In conclusion, although Takayasu's disease is progressive and the life expectancy is foreshortened, hypertension secondary to aortic and renal artery lesions is a frequent and important indication for aggressive operative treatment.- - - - - - - - - - ranking = 3keywords = hypertension (Clic here for more details about this article) |
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