An elderly female who survived more than 30 years following a diagnosis of Takayasu's arteritis, complicated by fatal intestinal amyloidosis.
Compared to young patients with Takayasu's arteritis (TA), little information about elderly patients with TA has been reported. Additionally, no reports were found regarding TA cases with complications of intestinal amyloidosis. This is a case report of an elderly female, who developed intestinal amyloidosis, during late-stage TA. After years of outpatient management, she developed sudden severe dyspnea with pulmonary effusion, requiring hospitalization. After this event, betamethasone was replaced by methotrexate (MTX) for the next 34 months, but it seemed ineffective. After 1.5 years, she developed intractable diarrhea, followed by increases in BUN and serum creatinine (Cr), requiring several courses of hemodialysis. Colonoscopy revealed the presence of amyloid in her intestine, although she died of complicated sepsis caused by MRSA infection. This may be the first paper describing intestinal amyloidosis in a TA patient. Additionally, her case is rare in that she lived more than 30 years after the onset and diagnosis of TA.
Nakamura
S
S
Section of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Medical Clinic, Higashi Sakura 2-12-1, Higashi-ku, Nagoya, 461-0005, Japan. shinya-n@aichi-med-u.ac.jp
Morishita
M
M
Yang
C L
CL
Utsumi
K
K
Takada
H
H
Furuhashi
K
K
Sugiura
H
H
D000368:Aged; D000686:Amyloidosis / Q000150:complications*; D015901:Angiography, Digital Subtraction; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications*; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D016106:Methicillin Resistance; D008727:Methotrexate / Q000627:therapeutic use; D013902:Radiography, Thoracic; D012120:Respiration Disorders / Q000000981:diagnostic imaging / Q000209:etiology; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology; D013210:Staphylococcus / Q000502:physiology; D013625:Takayasu Arteritis / Q000150:complications*; D017211:Treatment Failure
D008727:Methotrexate