Assessment of latent tuberculosis infection in Takayasu arteritis with tuberculin skin test and Quantiferon-TB Gold test

Karadağ, Ömer; Aksu, Kenan; Şahin, Abdurrahman; Zihni, Figen Yargucu; Şener, Burçin; İnanç, Nevsun; Kalyoncu, Umut; Aydın, Sibel Zehra; Aşçıoğlu, Sibel; Ocakçı, Pınar Talu; Bilgen, Şule Apraş; Keser, Gökhan; Inal, Vedat; Direşkeneli, Haner; Çalgünerı, Meral; Ertenli, İhsan; Kiraz, Sedat

doi:10.1007/s00296-010-1444-z

Cited by 35 publications

(21 citation statements)

References 16 publications

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“…Se inició tratamiento con metotrexato 20 mg semanal y prednisona 25 mg/día, a los 15 días de ingreso al servicio. Debido a la relación de tuberculosis y arteritis de Takayasu (13) , se solicitó interferón gamma (Quantiferon TB gold), resultando positivo. Ante ausencia de otros hallazgos en la tomografía espiral multicorte de tórax, se planteó el diagnostico de tuberculosis latente y se inició tratamiento con isoniacida 300 mg, a las tres semanas después de su ingreso al servicio.…”

Section: Caso Clínicounclassified

Presentación de un caso de arteritis de Takayasu en un adolescente

Aranda-Paniora¹,

Montoya²,

Vilca³

2016

An Fac med

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ResumenLa arteritis de Takayasu es una entidad rara en pediatría y su presentación clínica plantea diversos diagnósticos diferenciales. Se publica el caso de un adolescente de 14 años que ingresó a un Hospital de Lima con convulsiones tónico clónicas generalizadas e hipertensión arterial de grado 2. Posteriormente fue derivado para estudio al Instituto de Salud del Niño de Lima, Perú. Se revisa los criterios diagnósticos, su evolución y tratamiento. Palabras clave. Arteritis de Takayasu; Hipertensión Arterial; Pediatría. Abstract Takayasu arteritis is a rare entity in pediatrics and clinical presentation raises several differential diagnoses. We report the case of a 14-year-old boy with generalized tonic clonic seizures and stage 2 hypertension referred for study to the Instituto Nacional de Salud del Niño in Lima, Peru. Diagnostic criteria, evolution and treatment are reviewed. Keywords. Takayasu's Arteritis; Hypertension; Pediatrics. An Fac med. 2016;77(2):167-70 / http://dx

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Section: Caso Clínicounclassified

Presentación de un caso de arteritis de Takayasu en un adolescente

Aranda-Paniora¹,

Montoya²,

Vilca³

2016

An Fac med

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“…An association between mycobacterium tuberculosis (TB) and TA has been suggested based on a higher incidence of positive tuberculin skin tests than seen in controls in Turkish cohorts [17]. In addition, mycobacterium heat shock protein (mHSP)-65 and its human homologue, heat shock protein (hHSP)-60, induce T-cell proliferation (predominately CD4) to a greater degree than noted in healthy controls.…”

Section: Role Of Infectious Diseasementioning

confidence: 99%

“…However, conclusive evidence linking TB to the etiology of TA does not yet exist. In fact, in one study TA patients had similar rates of latent TB compared to controls, as measured by a serum quantiferon gold assay [17].There is no definitive evidence of an infectious trigger; however, intriguing evidence continues to emerge. Many agents have the capacity to causearteritis, however, the actual event is rare, implying a need for co-factors, including predisposition of the host.…”

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confidence: 99%

“…Interferon-γ (IFN-γ) plays a major role in controlling this process as IFN-γ receptor knockout mice and chronically INF-γ depleted mice develop more persistent necrotizing arteritis affecting the aortic root. Interestingly, B-cell deficient mice infected with γ-HV68 also develop aortitis [15,16].An association between mycobacterium tuberculosis (TB) and TA has been suggested based on a higher incidence of positive tuberculin skin tests than seen in controls in Turkish cohorts [17]. In addition, mycobacterium heat shock protein (mHSP)-65 and its human homologue, heat shock protein (hHSP)-60, induce T-cell proliferation (predominately CD4) to a greater degree than noted in healthy controls.…”

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confidence: 99%

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Insights into Pathogenesis of Takayasus Arteritis

Springer¹

2012

Transl Med

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Takayasu's arteritis (TA) is an idiopathic large vessel inflammatory disease that predominantly affects young women. The pathology includes granulomatous changes. The inflammatory process favors the cervico-cranial vessels of the aortic arch, the thoracic more than the abdominal aorta and produces stenoses 4-5 times more often than aneurysms (Figure 1) [1,2]. Wider global recognition of TA has led to questioning of the accuracy of the longaccepted demographic of an Asian stereotype and the notion that the illness follows a triphasic (systemic, vascular inflammatory and burned out) course. Larger aggregate data has also increased appreciation of persistent disease activity, need for surgical remedies and a greater degree of disability than heretofore recognized. Recent insights into pathogenesis have led to experimental trials of novel therapies. This review will explore these insights and resultant changes in both medical and surgical interventions. Historical BackgroundThe first recognition of TA is most often credited to Mikito Takayasu (1905-Japanese Ophthalmology Society Annual Meeting). However, there are earlier descriptions of TA by G.B. Morgagni and William Savory [3,4]. In 1761 Morgagni described a 40 year old female who lost her radial pulses years before her death. Postmortem findings included subclavian obstruction and severe aortic changes characterized by ectasias, aneurysms and stenosis. In 1856 Savory described a 22 year old female with bruits over the left carotid artery and sternum as well as weak pulses in the femoral arteries. Postmortem examination revealed the inner layers of the arteries appeared to be thickened and have a 'wrinkled' appearance similar to what is called a 'tree barking' today. He noted that the arteries and not the veins were affected and collateralization can appear around obliterated segments. He reasoned that inflammation was the underlying cause and the disease likely progressed over long periods of time and could be asymptomatic. The detailed and insightful observations noted by both Morgagni and Savory deserve to be remembered. EpidemiologyMedian age at disease onset in most series is 25-30 years. Females are affected at least 8 times more often than males. [6] tend to be younger (mean age at diagnosis ~25 years) than patients in Italy and France (mean age at diagnosis ~ 30-40 years) [7,8]. Some investigators do not define TA as a disease of younger individuals and some series include elderly patients. The lack of consensus regarding age as a criterion produces bias in demographic comparisons. Cohorts in Japan, Korea, the United States, France and Italy [2,5,7,8,9] include ~80-90% females; those from India have about 60% females [10]. In Japan almost all patients are Japanese, in the US and Italy patients are predominantly Caucasian. Morbidity and MortalityWhile the five year survival of TA remains favorable (~94%), the disease related morbidity can be devastating. Claudication symptoms are common and affect activities of daily living in 60% of patients. Re...

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“…This test has been particularly helpful in countries in which the interpretation of PPD intradermal reaction is confounded because routinely early application of BCG vaccine (Lalvani, 2007). Recently, Karadag and colleagues assess the possibility of latent tuberculosis infection in ninety-four Turkish patients with Takayasu's arteritis using tuberculin test and Quantiferon-TB Gold test and compare it with healthy controls (Karadag et al, 2010). Even when tuberculin test positivity was higher in patients with Takayasu's arteritis than in controls (62.5% versus 41.4%; P=0.008), Quantiferon-TB Gold test positivity was equal between groups (22.3% versus 22.4%; P>0.05), suggesting that latent tuberculosis is similar in patients with Takayasu's arteritis and in healthy controls.…”

Section: Absence Of Mycobacterium Tuberculosis In Arterial Tissue Fromentioning

confidence: 99%