Journal of Clinical Pediatrics ›› 2021, Vol. 39 ›› Issue (5): 360-.doi: 10.3969/j.issn.1000-3606.2021.05.009

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Crohn's disease complicated with Takayasu arteritis: a case report and literature review

MENG Yingying, WANG Yuhuan, TANG Zifei, WU Jie, TANG Wenjuan, HUANG Ying   

  1. Department of Gastroenterology, Children’s Hospital, Fudan University, Shanghai 201102 , China
  • Published:2021-05-07

Abstract: Objective To explore the understanding of Crohn's disease (CD) with Takayasu arteritis (TA) in children. Method The clinical data of CD with TA in a child were retrospectively analyzed, and the related literature was reviewed. Results A 10 -year-old girl was diagnosed with CD by colonoscopy and received infliximab (IFX) at follow-up. Three years later, the patient developed dizziness and syncope during the clinical remission phase, and TA was diagnosed by vascular ultrasonography and CT angiography. After stopping IFX treatment and starting glucocorticoid and mycophenolate mofetil, both CD and TA were relieved. Through literature review, it is found that CD combined with TA is more common in young women, and CD is more common in the first episode. The clinical manifestations of CD combined with TA are various, and the most common were nonspecific systemic symptoms and gastrointestinal symptoms. The clinical manifestations of TA in children are more atypical, and it is easy to be missed or misdiagnosed when combined with CD. The detection of blood pressure, pulse and vascular murmur is helpful to the diagnosis of TA. Once TA is suspected, vascular imaging should be performed as soon as possible. Most of the patients with CD and TA received combined therapy of mesalazine, glucocorticoid and immunosuppressive agents, some of them received biological agents, and more than 1 / 3 of them received surgical treatment. Conclusion CD combined with TA is rare. When there are differences in the inflammatory indexes and the clinical treatment effect among CD patients, it should be alerted whether they are complicated with other diseases.

Key words: Crohn’s disease; Takayasu arthritis; infliximab; child