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Takayasu's arteritis and Crohn's disease: an unusual association. Report on two cases
P Biagi1, R Castro, G Campanella
1Department of Internal Medicine, Tuscan Region, Local Health Unit ASL 7, Abbadia S. Salvatore (SI), Italy.
Insights
This study details two rare cases of Takayasu arteritis (TA) co-occurring with Crohn's disease (CD) in young women. The findings explore the unusual association between these two immune-mediated conditions.
Area of Science:
- Rheumatology
- Gastroenterology
- Vascular Medicine
Background:
- Takayasu arteritis is a rare, large-vessel vasculitis primarily affecting young women.
- Crohn's disease is a chronic inflammatory bowel disease of unknown etiology.
- The co-occurrence of these two immune-mediated diseases is exceptionally rare.
Observation:
- Two young female patients presented with Takayasu arteritis and Crohn's disease.
- Case 1 showed widespread vasculitis with an "Indian" angiographic pattern; Crohn's disease preceded TA.
- Case 2 exhibited "Japanese" aortic arch involvement; TA preceded Crohn's disease.
Findings:
- The association between Takayasu arteritis and Crohn's disease is uncommon.
- Steroid treatment may have influenced the natural course of both diseases in these patients.
- The coexistence of two distinct immune-mediated diseases in one individual challenges their perceived independence.
Implications:
- This rare association prompts further investigation into potential shared etiological factors or pathogenetic mechanisms.
- Understanding the interplay between TA and CD could lead to improved diagnostic and therapeutic strategies.
- Further research is needed to elucidate the relationship between these two immune-mediated conditions.
Abstract:
Two cases of Takayasu's arteritis associated with Crohn's disease of the colon are described, both of which occurring in young female patients. In the first case, the vasculitic process was widespread, involving the aortic arch, the abdominal aorta, the renal arteries and the left iliac artery, similar to the angiographic "Indian" pattern. The second case presented a typical "Japanese" aortic arch involvement. In the first patient, Crohn's disease appeared to have been present prior to Takayasu's arteritis, vice versa in the second case; steroid treatment, assigned for both diseases might, however, have modified their natural evolution. The association is rare. Moreover, the coexistence of two immune-mediated diseases in the same subject is unusual as they are generally considered to be independent. Hypotheses concerning their possible inter-relationship are advanced.