新发溃疡性结肠炎的年轻白人妇女未分类动脉炎。

Case Reports in Vascular Medicine Pub Date : 2022-01-07 eCollection Date: 2022-01-01 DOI:10.1155/2022/7773222
Bryan Roberts
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引用次数: 0

摘要

高须动脉炎是一种罕见的疾病,多见于亚洲人群。在炎症性肠病患者中已有病例报告,提示可能存在遗传联系。本临床病例报告的目的是强调一个罕见的动脉炎体征和症状的发现,在一个32岁的白人妇女(可能早期,它还没有达到官方诊断的分类为Takayasu动脉炎),随后被诊断为溃疡性结肠炎几个月后。患者就诊时右侧颈动脉分布区周围出现搏动性颈部疼痛和压痛,非特异性视觉改变,双侧上肢感觉异常,近期门诊颈动脉多普勒超声检查发现右侧颈动脉狭窄50-69%。根据医院的其他实验室、临床和高级影像学检查结果,诊断为动脉炎,尚不能归类为高须动脉炎,并给予患者皮质类固醇治疗。不幸的是,她出现了心动过缓,这后来被归因于皮质类固醇疗法,并停止了药物治疗。通过在诊所的随访,患者的颈痛症有所改善,但现在,她报告了三个月的血便史。结肠镜检查和病理结果与溃疡性结肠炎一致,患者开始使用美沙拉明。炎症性肠病和高须动脉炎的相关性不应被忽视,因为未来的治疗方法和早期持续监测可能对改善生活质量和避免严重并发症至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
New-Onset Ulcerative Colitis in a Young Caucasian Woman with Unclassified Arteritis.

Takayasu arteritis is a rare disease mostly found in Asian populations. Cases have been reported in patients with inflammatory bowel disease, suggesting possible genetic linkage. The objective of this clinical case report is to highlight a rare finding of arteritis signs and symptoms in a 32-year-old Caucasian woman (likely early that it did not yet meet classification for official diagnosis as Takayasu arteritis) who subsequently was diagnosed with ulcerative colitis a few months later. The patient presented to the hospital with throbbing neck pain and tenderness around the area of her right carotid artery distribution, nonspecific visual changes, and bilateral upper extremity paresthesia, with significant findings of 50-69% right carotid artery stenosis on a recent outpatient carotid Doppler ultrasound. Based on additional laboratory, clinical, and advanced imaging findings at the hospital, a diagnosis of arteritis not yet classifiable as Takayasu arteritis was made, and the patient was treated with corticosteroids. Unfortunately, she developed bradycardia that was later attributed to the corticosteroid regimen and the medication was discontinued. By follow-up in the clinic, the patient's carotidynia improved, but now, she reported a three-month history of bloody stools. Colonoscopy and pathology findings were consistent with ulcerative colitis, and the patient was started on mesalamine. The association of inflammatory bowel disease and Takayasu arteritis should not be overlooked, as future treatment methods and early, continuous surveillance may be critical in improving quality of life and avoiding serious complications.

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