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| Authors | B Coleiro P J Cassar K Cassar L Azzopardi C Mallia |
| Abstract | Takayasus arteritis is a chronic inflammatory disease of unknown aetiology that affects predominantly the aorta and its major branches. The clinical features vary depending on which arteries are involved. We present the case of a female patient who was diagnosed with this condition at the age of 27 years. The brunt of her disease fell on the arch of the aorta and coronary arteries resulting in aortic valve incompetence and recurrent symptoms of angina pectoris that eventually necessitated aortic valve replacement surgery and coronary artery bypass grafting. There was a satisfactory response but 12 years later anginal symptoms recurred. At this stage immunosuppressant treatment was administered with intravenous pulsed methylprednisolone and cyclophosphamide. This resulted in symptomatic relief but 10 years later there was a further recurrence of angina that persisted despite an angioplasty to one of the stenosed graft vessels and maximisation of antianginal treatment. Considering the effectiveness of biological agents such as etanercept as potent suppressors of autoimmune inflammatory disease and based on a few scant reports in the literature about their use in refractory Takayasus arteritis, it was decided to add etanercept to this patients treatment. The effect was dramatic with complete resolution of symptoms and a reduction in the ESR. This is the first time a biological agent has been used to treat Takayasus arteritis in Malta and adds to the growing literature on the efficacy of these agents in this condition. |
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| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
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| Key words | case report, etanercept, takayasu arteritis, TNF blocker |