Takayasu Arteritis Coexisting with Cutaneous Leishmaniasis
Takayasu arteritis (TA) is a rare large-vessel vasculitis that can result in significant morbidity and mortality. The coexistence of TA with leishmaniasis infection has not been reported previously. Case description: An 8-year-old girl presented with recurrent skin nodules that heal spontaneously fo...
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MDPI AG
2023-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/5/1819 |
| _version_ | 1797615037702995968 |
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| author | Mutong Zhao Ying Liu Zhihai Hu Juan Sun Zhou Yang Li Wei Zigang Xu Lin Ma |
| author_facet | Mutong Zhao Ying Liu Zhihai Hu Juan Sun Zhou Yang Li Wei Zigang Xu Lin Ma |
| author_sort | Mutong Zhao |
| collection | DOAJ |
| description | Takayasu arteritis (TA) is a rare large-vessel vasculitis that can result in significant morbidity and mortality. The coexistence of TA with leishmaniasis infection has not been reported previously. Case description: An 8-year-old girl presented with recurrent skin nodules that heal spontaneously for four years. Her skin biopsy revealed granulomatous inflammation with Leishmania amastigotes identified in the histocyte cytoplasm and the extracellular space. The diagnosis of cutaneous leishmaniasis was made and intralesional sodium antimony gluconate was started. One month later, she experienced dry coughs and fever. The CT angiography of the carotid arteries showed dilation in the right common carotid artery and thickening of artery walls with elevated acute phase reactants. The diagnosis of Takayasu arteritis (TA) was made. Reviewing her chest CT before treatment, a soft-tissue density mass was identified in the right carotid artery region, suggesting a pre-existing aneurysm. The patient was treated with surgical resection of the aneurysm with systemic corticosteroids and immunosuppressants. Her skin nodules resolved with scars after the second cycle of antimony while a new aneurysm arose due to a lack of control of TA. Conclusions: This case highlights that benign as the natural course is for cutaneous leishmaniasis, fatal comorbidities can occur as a consequence of chronic inflammation, and can be aggravated by the treatment. |
| first_indexed | 2024-03-11T07:20:48Z |
| format | Article |
| id | doaj.art-a45919e1b2e942c8a3e4dd11de48ab04 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:20:48Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a45919e1b2e942c8a3e4dd11de48ab042023-11-17T07:58:46ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01125181910.3390/jcm12051819Takayasu Arteritis Coexisting with Cutaneous LeishmaniasisMutong Zhao0Ying Liu1Zhihai Hu2Juan Sun3Zhou Yang4Li Wei5Zigang Xu6Lin Ma7Department of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, ChinaDepartment of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, ChinaDepartment of Medical Imaging, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaDepartment of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, ChinaDepartment of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, ChinaDepartment of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, ChinaDepartment of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, ChinaDepartment of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, ChinaTakayasu arteritis (TA) is a rare large-vessel vasculitis that can result in significant morbidity and mortality. The coexistence of TA with leishmaniasis infection has not been reported previously. Case description: An 8-year-old girl presented with recurrent skin nodules that heal spontaneously for four years. Her skin biopsy revealed granulomatous inflammation with Leishmania amastigotes identified in the histocyte cytoplasm and the extracellular space. The diagnosis of cutaneous leishmaniasis was made and intralesional sodium antimony gluconate was started. One month later, she experienced dry coughs and fever. The CT angiography of the carotid arteries showed dilation in the right common carotid artery and thickening of artery walls with elevated acute phase reactants. The diagnosis of Takayasu arteritis (TA) was made. Reviewing her chest CT before treatment, a soft-tissue density mass was identified in the right carotid artery region, suggesting a pre-existing aneurysm. The patient was treated with surgical resection of the aneurysm with systemic corticosteroids and immunosuppressants. Her skin nodules resolved with scars after the second cycle of antimony while a new aneurysm arose due to a lack of control of TA. Conclusions: This case highlights that benign as the natural course is for cutaneous leishmaniasis, fatal comorbidities can occur as a consequence of chronic inflammation, and can be aggravated by the treatment.https://www.mdpi.com/2077-0383/12/5/1819leishmaniasisantimonyTakayasu arteritisinflammationinfection |
| spellingShingle | Mutong Zhao Ying Liu Zhihai Hu Juan Sun Zhou Yang Li Wei Zigang Xu Lin Ma Takayasu Arteritis Coexisting with Cutaneous Leishmaniasis Journal of Clinical Medicine leishmaniasis antimony Takayasu arteritis inflammation infection |
| title | Takayasu Arteritis Coexisting with Cutaneous Leishmaniasis |
| title_full | Takayasu Arteritis Coexisting with Cutaneous Leishmaniasis |
| title_fullStr | Takayasu Arteritis Coexisting with Cutaneous Leishmaniasis |
| title_full_unstemmed | Takayasu Arteritis Coexisting with Cutaneous Leishmaniasis |
| title_short | Takayasu Arteritis Coexisting with Cutaneous Leishmaniasis |
| title_sort | takayasu arteritis coexisting with cutaneous leishmaniasis |
| topic | leishmaniasis antimony Takayasu arteritis inflammation infection |
| url | https://www.mdpi.com/2077-0383/12/5/1819 |
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