title: Crohn's disease and Takayasu's arteritis: an uncommon association.
abstract: Takayasu's arteritis (TA) and Crohn's disease (CD) are two rare autoimmune disorders; however some reports describe the presence of both diseases in the same patient. This finding has suggested the possibility that both diseases could share some common etiologic origin. We describe a case of a 13-year-old male affected by CD characterized by fever, diarrhea, weight loss, abdominal pain and elevation of inflammatory markers. Clinical and histological features from colonic specimens were consistent with CD. Treatment with steroids and azathioprine was started, however disease flared every time steroids were tapered. One year later, while still on treatment, he came back to our attention for dyspnea at rest and at night, tiredness and weakness. At physical examination a diastolic heart murmur was found as well as a left carotid artery bruit. A transthoracic echocardiography showed mild aortic valve insufficiency, left ventricular hypertrophy and a dilated ascending aorta with same findings at the aortic arch. A computed tomography scan showed abdominal aorta thickening, dilated thoracic aorta and the presence of a thoracic aortic aneurysm. TA associated with CD was diagnosed and medical treatment with cyclophosphamide, steroids and aminosalicylic acid was started, with good clinical response at 6 mo follow-up. We discuss the presence of possible common causes for the two diseases and the importance of differential diagnosis in those patients characterized for intractable disease.
authors.affiliation: Andrea Taddio, Alessandro Ventura, Institute of Child Health, IRCCS "Burlo Garofolo", Trieste and University of Trieste, 341000 Trieste, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Taddio
authors.forename: Massimo
authors.initials: M
authors.lastname: Maschio
authors.forename: Stefano
authors.initials: S
authors.lastname: Martelossi
authors.forename: Egidio
authors.initials: E
authors.lastname: Barbi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ventura
mesh_terms: D000293:Adolescent; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D013256:Steroids / Q000627:therapeutic use; D013625:Takayasu Arteritis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids
keywords: Crohn’s disease; Intractable inflammatory bowel disease; Takayasu arteritis; Treatment; children