Gangrene in Takayasu's arteritis: a report of two cases and review of literature

Rheumatol Int. 2016 Mar;36(3):449-53. doi: 10.1007/s00296-015-3392-0. Epub 2015 Nov 12.

Abstract

Takayasu's arteritis (TA) is a granulomatous large vessel vasculitis more commonly seen in India. The vascular inflammation in TA results in stenoses of affected vessels. Usually this is a slow process with good collateral circulation; only rarely does critical limb ischemia result. We present two patients of TA who presented with gangrene of extremities, and review eight prior such patients reported in the literature. With appropriate diagnosis and treatment with oral corticosteroids and low-dose aspirin, none of our patients had recurrence at a mean follow-up of 3.8 ± 2.8 years. Although rare, TA can present with gangrene and rheumatologists need to be aware of this unusual but limb-threatening manifestation of TA to institute appropriate therapy in a timely manner.

Keywords: Critical limb ischemia; Gangrene; Takayasu’s arteritis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Amputation, Surgical
  • Anticoagulants / administration & dosage
  • Aspirin / administration & dosage
  • Critical Illness
  • Female
  • Gangrene
  • Humans
  • Ischemia / diagnosis
  • Ischemia / etiology*
  • Ischemia / therapy
  • Lower Extremity / blood supply*
  • Magnetic Resonance Angiography
  • Male
  • Takayasu Arteritis / complications*
  • Takayasu Arteritis / diagnosis
  • Takayasu Arteritis / drug therapy
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Anticoagulants
  • Aspirin