https://doi.org/10.4081/reumatismo.2024.1678
Inflammatory back pain as an unusual manifestation of Takayasu arteritis: a case report
Submitted: 1 November 2023
Accepted: 9 July 2024
Published: 30 October 2024
Accepted: 9 July 2024
Abstract Views: 51
PDF: 11
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Takayasu arteritis and spondyloarthritis are two rheumatological diseases whose co-existence is well-documented in the literature. Data on the presence of inflammatory back pain in Takayasu arteritis without a diagnosis of spondyloarthritis, however, is scarce. Here, we present a 33-year-old man who was admitted to the emergency department with acute-onset chest pain associated with left carotidynia, carotid bruit, and left arm claudication, normal electrocardiogram and computed tomography angiographic features suggesting Takayasu arteritis, including stenosis and occlusion of the aorta and its branches. Two years prior, he had undergone a clinical work-up for an inflammatory back pain accompanied by alternating buttocks pain, morning stiffness lasting more than half an hour, and heel pain. HLA-B27 status and magnetic resonance imaging of the sacroiliac joints were both negative. He was prescribed non-steroidal anti-inflammatory drugs and was placed on adalimumab 40 mg SC every two weeks but had to switch to etanercept two months before his emergency admission due to supply issues. Oral prednisolone was initiated at a dose of 60 mg/day with symptomatic improvement in both his inflammatory back pain and his chest pain, but he had to be switched to methotrexate and infliximab due to steroid side effects. Inflammatory aortitis should be considered as a possibility during the assessment of inflammatory back pain to mitigate the risks of delayed diagnosis.
Park M, Lee S, Park Y, Chung NS, Lee S. Clinical characteristics and outcomes of Takayasu’s arteritis: Analysis of 108 patients using standardized criteria for diagnosis, activity assessment, and angiographic classification. Scand J Rheumatol 2005; 34: 284-92.
DOI: https://doi.org/10.1080/03009740510026526
Kerr GS. Takayasu arteritis. Ann Intern Med 1994; 120: 919-29.
DOI: https://doi.org/10.7326/0003-4819-120-11-199406010-00004
Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O’Dell JR. Firestein & Kelley’s textbook of rheumatology. Philadelphia, PA: Elsevier; 2021.
Esatoglu SN, Ok AM, Ucar D, Celik AF, Ugurlu S, Hamuryudan V, et al. Takayasu’s arteritis: associated inflammatory diseases. Clin Exp Rheumatol 2020; 38: 61-8.
Mielnik P, Hjelle AM, Nordeide JL. Coexistence of Takayasu’s arteritis and ankylosing spondylitis may not be accidental – is there a need for a new subgroup in the spondyloarthritis family? Mod Rheumatol 2017; 28: 313-8.
DOI: https://doi.org/10.1080/14397595.2017.1341592
Güzel Esen S, Armagan B, Atas N, Ucar M, Varan Ö, Erden A, et al. Increased incidence of spondyloarthropathies in patients with Takayasu arteritis: a systematic clinical survey. Joint Bone Spine 2019; 86: 497-501.
DOI: https://doi.org/10.1016/j.jbspin.2019.01.020
Loricera J, Blanco R, Hernández JL, Carril JM, Martínez-Rodríguez I, Canga A, et al. Non-infectious aortitis: a report of 32 cases from a single tertiary centre in a 4-year period and literature review. Clin Exp Rheumatol 2015; 33: 19-31.
Sieper J, Rudwaleit M, Baraliakos X, Brandt J, Braun J, Burgos-Vargas R, et al. The assessment of Spondyloarthritis International Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis 2009; 68: ii1-44.
DOI: https://doi.org/10.1136/ard.2008.104018
Grayson PC, Ponte C, Suppiah R, Robson JC, Gribbons KB, Judge A, et al. 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis. Arthritis Rheumatol 2022; 74: 1872-80.
DOI: https://doi.org/10.1002/art.42324
Al-Bedri KZM. Prevalence, clinical features, and radiological features of Iraqi patients with ankylosing spondylitis. J Nat Sci Res 2014; 4: 53.
Abdelrahman MH, Mahdy S, Khanjar IA, Siam AM, Malallah HA, Al-Emadi SA, et al. Prevalence of HLA-B27 in patients with ankylosing spondylitis in Qatar. Int J Rheumatol 2012; 2012: 860213.
DOI: https://doi.org/10.1155/2012/860213
Brown MA, Pile KD, Kennedy LG, Calin A, Darke C, Bell J, et al. HLA class I associations of ankylosing spondylitis in the white population in the United Kingdom. Ann Rheum Dis 1996; 55: 268-70.
DOI: https://doi.org/10.1136/ard.55.4.268
van Onna M, Jurik AG, van der Heijde D, van Tubergen A, Heuft-Dorenbosch L, Landewe R. HLA-B27 and gender independently determine the likelihood of a positive MRI of the sacroiliac joints in patients with early inflammatory back pain: a 2-year MRI follow-up study. Ann Rheum Dis 2011; 70: 1981-5.
DOI: https://doi.org/10.1136/annrheumdis-2011-200025
Rudwaleit M, van der Heijde D, Landewe R, Akkoc N, Brandt J, Chou CT, et al. The assessment of Spondyloarthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis 2010; 70: 25-31.
DOI: https://doi.org/10.1136/ard.2010.133645
Erbasan F, Uçar I, Aslan B, Yazisiz V, Terzioğlu ME. The effects of biological agents on vascular structural lesions in Takayasu's arteritis. Clin Exp Rheumatol 2021; 129: 135-41.
DOI: https://doi.org/10.55563/clinexprheumatol/z6drbj
How to Cite
Gorial, F., Awadh, N., Al-Shakarchi, A., & Al-Gburi, G. (2024). Inflammatory back pain as an unusual manifestation of Takayasu arteritis: a case report. Reumatismo. https://doi.org/10.4081/reumatismo.2024.1678
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Similar Articles
- F.M. Perrotta, O. Addimanda, R. Ramonda, S. D’Angelo, E. Lubrano, A. Marchesoni, I. Olivieri, L. Punzi, C. Salvarani, A. Spadaro, Predictive factors for partial remission according to the Ankylosing Spondylitis Assessment Study working group in patients with ankylosing spondylitis treated with anti-TNFα drugs , Reumatismo: Vol. 66 No. 3 (2014)
- B. Ruaro, A. Sulli, E. Alessandri, F. Ravera, M. Cutolo, Coexistence of osteopoikilosis with seronegative spondyloarthritis and Raynaud’s phenomenon: first case report with evaluation of the nailfold capillary bed and literature review , Reumatismo: Vol. 64 No. 5 (2012)
- A. Lo Gullo, G. Mandraffino, C.O. Aragona, A. Molica Colella, A. Saitta, E. Imbalzano, Subcutaneous administration of tocilizumab is effective in myointimal hyperplasia remodelling in refractory Takayasu arteritis , Reumatismo: Vol. 69 No. 4 (2017)
- L. Magnani, A. Versari, D. Salvo, M. Casali, G. Germanò, R. Meliconi, L. Pulsatelli, D. Formisano, G. Bajocchi, N. Pipitone, L. Boiardi, C. Salvarani, Disease activity assessment in large vessel vasculitis , Reumatismo: Vol. 63 No. 2 (2011)
- W. Häuser, F. Wolfe, Diagnosis and diagnostic tests for fibromyalgia (syndrome) , Reumatismo: Vol. 64 No. 4 (2012)
- G. Lopalco, F. Iannone, D. Rigante, A. Vitale, M.E. Mancini, M. Covelli, G. Lapadula, L. Cantarini, Coexistence of axial spondyloarthritis and thromboangiitis obliterans in a young woman , Reumatismo: Vol. 67 No. 1 (2015)
- V. Picerno, G. Filippou, I. Bertoldi, A. Adinolfi, V. Di Sabatino, M. Galeazzi, B. Frediani, Prevalence of Baker’s cyst in patients with knee pain: an ultrasonographic study , Reumatismo: Vol. 65 No. 6 (2013)
- A. Fassio, L. Idolazzi, M. Rossini, O. Viapiana, D. Gatti, A case of mandible Paget’s disease of the bone treated with intravenous neridronate , Reumatismo: Vol. 68 No. 3 (2016)
- F. Atzeni, S. Sallì, M. Benucci, M. Di Franco, R. Casale, A. Alciati, P. Sarzi-Puttini, Fibromyalgia and arthritides , Reumatismo: Vol. 64 No. 4 (2012)
- M. de Oliveira Paes Leme, S.L.K. Yuan, M. Oliveira Magalhães, S.R. Ferreira de Meneses, A.P. Marques, Pain and quality of life in knee osteoarthritis, chronic low back pain and fibromyalgia: a comparative cross-sectional study , Reumatismo: Vol. 71 No. 2 (2019)
<< < 1 2 3 4 5 6 7 8 9 10 > >>
You may also start an advanced similarity search for this article.
