Navegando por Palavras-chave "Takayasu Arteritis"

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    Arterite de Takayasu na gestação: relato de caso e revisão de literatura
    (Elsevier B.V., 2011-07-01) Leal, Plínio da Cunha [UNIFESP]; Silveira, Fernanda Fabrizia Martins [UNIFESP]; Sadatsune, Eduardo Jun [UNIFESP]; Clivatti, Jefferson [UNIFESP]; Yamashita, Americo Masafuni [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background and objectives: Takayasus's Arteritis (TA) is a chronic, inflammatory, progressive, idiopathic disease that causes narrowing, occlusion, and aneurysms of systemic and pulmonary arteries affecting especially the aorta and its branches. During pregnancy, one should pay special attention to these patients. The objective of this report was to present the peripartum anesthetic care of a patient with TA and a review of the literature.Case report: This is a 31-year old gravida who underwent exchange of the aortic arch and placement of a metallic aortic valve for TA four years ago. She had no complications during pregnancy, and she was admitted at 34 weeks of pregnancy for anticoagulation management. Elective cesarean section was performed at 39 weeks with continuous epidural anesthesia. Fractionated doses of local anesthetic were administered to guarantee slow installation of the blockade. The patient remained hemodynamically stable and was transferred to the ICU in the postoperative period.Conclusions: Several complications can affect gravidas with TA. Careful patient evaluation, treatment of TA complications, and anesthetic-surgical planning are fundamental. Maintenance of perfusion is the main concern in these patients, and neuraxial blocks may be used without harming the mother and fetus. In patients with compensated TA complications, monitoring does not differ from that routinely used in cesarean sections. Continuous epidural anesthesia with slow installation maintains hemodynamic stability and allows monitoring cerebral perfusion through the level of consciousness. To avoid postoperative hypoperfusion or hypertensive complications patients should be monitored in an intensive or semi-intensive care unit for 24 hours.
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    Avaliação do infiltrado de macrófagos na parede arterial de pacientes com arterite de takayasu.
    (Universidade Federal de São Paulo (UNIFESP), 2019-04-24) Santos, Joao Paulo Dos [UNIFESP]; Souza, Alexandre Wagner Silva De [UNIFESP]; http://lattes.cnpq.br/7033230017001241; http://lattes.cnpq.br/2564736745724709; Universidade Federal de São Paulo (UNIFESP)
    Introduction – Takayasu's arteritis (TA) is a systemic vasculitis of unknown etiology that affects large arteries, such as the aorta and its main branches. The inflammatory infiltrate of the arterial wall consists of macrophages, multinucleated giant cells, natural killer (NK) cells, neutrophils and CD4+ T cells, CD8+ T cells and γδ T cells. No studies have evaluated macrophages phenotypes present in the inflammatory infiltrate of the arterial walls in patients with TA. Objective – The primary aim of this study was to evaluate which macrophage phenotype is predominant in the inflammatory infiltration in the aorta of patients with TA. Secondary study aims were to compare the frequency of macrophages, T cells, B cells and NK cells in the aorta from TA patients, patients with atherosclerotic disease (AD) and healthy controls (HC); to describe the predominant localization of macrophages in the aorta from TA patients; to analyze associations between infiltration of macrophages and T cells, B cells and NK cells in the arterial wall and clinical disease activity, histological disease activity, concomitant atherosclerotic lesions and prednisone use. Materials and Methods – We performed a cross-sectional study using immunohistochemistry to evaluate the expression of macrophages (CD68), T cells (CD3), B cells (CD20), NK cells (CD56), as well as M1 (CD86) and M2 (CD206) macrophages in inflammatory infiltration in the aorta from TA patients (n = 22), patients with AD of the aorta (n = 9) and HC (n = 8). Results – The thoracic aorta was assessed in 86.4% of TA patients, in 77.8% of patients with atherosclerotic disease and in 100% of controls. The abdominal aorta was evaluated in remainder. The surgical procedure was performed at the time of diagnosis in 54.5% of patients with TA. Clinical activity of the disease was observed in 54.5% of cases, histological activity in 40.9% and atherosclerotic lesions in 27.3% of patients with TA. Only 36.3% of the patients with TA were on glucocorticoid, immunosuppressive and/or biologic agents. The frequency of macrophages, M1 macrophages, T cells, B cells and NK cells was higher in the aorta from TA and AD patients compared with HC, but no differences were found among all groups for M2 macrophages. In TA, macrophages and T cells were the most abundant cells in the aorta while M2 macrophages were more frequently found than M1 macrophages. No differences were found concerning macrophages, T cells, Bcells or NK cells between TA patients presenting active disease and those in remission nor between TA patients with and without concomitant atherosclerotic lesions in the aorta. T cells were more frequent in the aorta of TA patients with active disease based on histological evaluation compared with those presenting chronic fibrotic lesions, but no differences were found in the expression of macrophage markers. The use of prednisone was associated with a significantly lower T cell count in the aorta of TA patients whereas no differences were observed for other cell markers. Conclusions – M2 macrophages are more frequently found in the aorta of TA patients than M1 macrophages. Macrophages and T cells are the most frequent cells in the inflammatory infiltrate in the aorta of TA patients. T cells were associated with histological disease activity and with prednisone use in TAK but not macrophages.
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    THORACIC OUTLET SYNDROME (TOS) MIMICKING TAKAYASU'S ARTERITIS - CASE REPORT
    (Medfarma-edicoes Medicas, Lda, 2009-01-01) Reis Neto, Edgard Torres dos [UNIFESP]; Pucinelli, Mario Luiz Cardoso [UNIFESP]; Souza, Alexandre Wagner Silva de [UNIFESP]; Sato, Emilia Inoue [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Thoracic outlet syndrome (TOS) is defined as a set of symptoms caused by the compression of the brachial plexus and subclavian vessels in the thoracic outlet region. Anomalies in musculoskeletal structures maybe responsible for TOS, including prolonged transverse process of the seventh cervical vertebra, cervical rib, and first anomalous rib and clavicle fractures. The authors describe a case of a young woman with pain in the left forearm, accompanied by intermittent claudication, weigh loss, myalgias and ischemic lesions in the fingers, with no pulses and no measurable blood pressure in the left arm, who was initially diagnosed as Takayasu arteritis. The chest radiography showed accessory cervical ribs and the dynamic vascular image tests (Doppler ultra-sound and angiography) showed bilateral compression of the subclavian artery, confirming the diagnosis of TOS