Takayasu arteritis in childhood: misdiagnoses at disease onset and associated diseases

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art_CLEMENTE_Takayasu_arteritis_in_childhood_misdiagnoses_at_disease_onset_2018.PDF (602.73 KB)
Citações na Scopus
23
Tipo de produção
article
Data de publicação
2018
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER HEIDELBERG
Autores
CLEMENTE, Gleice
SACCHETTI, Silvana B.
FERRIANI, Virginia P. L.
OLIVEIRA, Sheila K.
SZTAJNBOK, Flavio
BICA, Blanca E. R. G.
CAVALCANTI, Andre
ROBAZZI, Teresa
BANDEIRA, Marcia
Citação
RHEUMATOLOGY INTERNATIONAL, v.38, n.6, p.1089-1094, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Juvenile-Takayasu arteritis (j-TA) is a difficult diagnosis and some patients develop uncommon manifestations and associated diseases that may contribute to the delayed diagnosis. Our aim was to identify the misdiagnoses, the associated diseases and the atypical manifestations observed in a j-TA Brazilian multicentre study. 71 children and adolescents who met the classification criteria for j-TA were included. The misdiagnoses, the associated diseases and the atypical manifestations were evaluated. 19 (26.8%) patients had misdiagnoses. The most common of them was aortic coarctation in six (8.4%) patients, followed by rheumatic fever in five (7.0%) and one patient presented with both former diagnoses. Limb pain (two patients), spondyloarthropathy, juvenile idiopathic arthritis (JIA), spinal arteriovenous malformation, polyarteritis nodosa (PAN) and fever of unknown origin (FUO) were other misdiagnoses. Patients who had misdiagnoses previously to j-TA diagnosis presented a trend to have a longer diagnosis delay. 11 (15.5%) patients had 14 TA-associated diseases, such as pulmonary tuberculosis (5 patients), rheumatic fever (2 patients), spondyloarthropathy, polyarticular JIA, Crohn's disease, Prader-Willi disease, diabetes mellitus, Moyamoya and primary immunodeficiency. 7 (9.9%) patients presented 10 atypical manifestations, such as pyoderma gangrenosum, erythema nodosum, myositis, chorea, enthesitis, episcleritis, uveitis, hepatomegaly, splenomegaly and necrosis of extremities. Our study emphasizes the main misdiagnoses, associated diseases and atypical manifestations that occur in patients with j-TA and warns of the features that may alert paediatricians to this diagnosis, such as constitutional symptoms and elevated inflammatory markers.
Palavras-chave
Vasculitis, Takayasu arteritis, Childhood, Diagnosis, Adolescent
URI
https://observatorio.fm.usp.br/handle/OPI/27012
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - LIM/36
Artigos e Materiais de Revistas Científicas - ODS/03