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[Takayasu's disease: interest in methotrexate treatment]
L Besson-Léaud1, N Grenier, M Besson-Léaud
1Département de pédiatrie médicale, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France. laurentbessonleaud@hotmail.com
Summary
Methotrexate effectively treated Takayasu's arteritis in a pediatric patient unresponsive to steroids. This finding suggests methotrexate as a potential steroid-sparing agent for managing this rare aortic inflammation.
Area of Science:
- Rheumatology
- Pediatric Vasculitis
- Immunosuppressive Therapy
Background:
- Takayasu's arteritis is a rare, chronic inflammatory condition affecting the aorta and its branches.
- Standard treatment involves prolonged corticosteroid therapy, which can lead to significant side effects and dependency.
- Some patients exhibit resistance or intolerance to corticosteroids, necessitating alternative therapeutic strategies.
Observation:
- A 6-year-old girl diagnosed with Takayasu's arteritis presented with renovascular hypertension.
- Corticosteroids managed the inflammatory symptoms but failed to address renal involvement and growth impairment.
- The patient received methotrexate at a dose of 10 mg/m²/week.
Findings:
- Methotrexate administration led to effective disease control in the pediatric patient.
- The patient experienced a reduction in corticosteroid dosage.
- Normal growth was restored, indicating a positive impact on systemic health.
Implications:
- Methotrexate demonstrates potential efficacy as a steroid-sparing agent in pediatric Takayasu's arteritis.
- This case highlights methotrexate as a viable option for patients with refractory or steroid-dependent disease.
- Further research into methotrexate's role in managing Takayasu's arteritis is warranted.