Delayed Diagnosis of Ankylosing Spondylitis Associated with Takayasu Arteritis：A Case Report and Literature Review

JI Lian-mei; ZHAO Dong-bao

doi:10.3969/j.issn.1002-3429.2015.01.016

Abstract：Objective To investigate the clinical characteristics of the ankylosing spondylitis ( AS) with takayasu ar-teritis ( TA) so as to reduce misdiagnosis rate. Methods Retrospective analysis on clinical data of one case of AS merged with TA was made and the literature was reviewed. Results ① The 25-year-old male patient had a 5-year history of AS and suffered pulmonary infection and heart failure. The patient was transferred to our hospital after corresponding treatment with poor effect. With detailed examinations, relit radial pulse was found weaker and significant difference of the upper limbs blood pressure, vascular murmur of neck and left infraclavicula were found. Combined with carotid magnetic resonance angiography, additional diagnosis was made to confirm TA. After corticosteroids and cyclophosphamide treatment, the condition improved obviously. ②In PubMed and Cqvip periodical database, using AS+TA as the retrieval, 7 articles were hit with an accumula-tive total of 12 patients, mostly female, the majority of HLA-B27 was positive, occasionally negative. The 12 cases were first diagnosed as AS, and was later discovered to be merged with TA many years later, and inflammatory markers increased and vascular murmur was heard. Conclusion When the AS patients have fever, vascular murmur, pulseless, or no pulse, it should be taken as a warning that TA is merged. The association and coexistence of AS and TA are not accidental. However, it needs further study as to whether there is a genetic predisposition or not.