title: A case of Takayasu's arteritis detected in a patient with Crohn's disease following infliximab treatment.
abstract: A 19-year-old male with diarrhea, abdominal pain, fever, and elevated C-reactive protein (CRP) levels was admitted to our hospital. Endoscopic examination and small intestinal contrast radiography revealed multiple longitudinal ulcers in the large intestine and ileum. A specimen biopsied from one of these ulcers revealed non-caseating epithelioid cell granuloma. He also had a draining anal fistula. Plain chest computed tomography (CT) and abdominal contrast-enhanced CT did not reveal any vascular abnormality. A diagnosis of Crohn's disease was made, and infliximab was administered. Following infliximab administration, the diarrhea and abdominal pain disappeared, longitudinal ulcers in the large intestine healed (as evidenced by endoscopic examination), and his anal lesion improved. However, fever and elevated CRP levels persisted. With the concomitant use of prednisolone, the fever and elevation of CRP levels eventually improved, and the patient was discharged. Both, however, recurred as the patient was weaned off prednisolone treatment; consequently, he was re-hospitalized. Contrast-enhanced CT upon re-admission revealed stenoses of the right renal artery, left common carotid artery, and left subclavian artery. In addition to Crohn's disease, the patient was diagnosed with co-existing Takayasu's arteritis.
authors.affiliation: IBD Center, Sapporo Kosei General Hospital.
authors.forename: Maki
authors.initials: M
authors.lastname: Miyakawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Masaki
authors.initials: M
authors.lastname: Yamashita
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Sakemi
authors.forename: Masanao
authors.initials: M
authors.lastname: Nasuno
authors.forename: Manabu
authors.initials: M
authors.lastname: Ishii
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yanagisawa
authors.forename: Shin
authors.initials: S
authors.lastname: Ichihara
authors.forename: Hiroko
authors.initials: H
authors.lastname: Gotoda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Motoya
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D003424:Crohn Disease / Q000150:complications* / Q000000981:diagnostic imaging; D003967:Diarrhea / Q000209:etiology; D005334:Fever / Q000209:etiology; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D013625:Takayasu Arteritis / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000069285:Infliximab