J Rheum Dis.  2016 Feb;23(1):71-75. 10.4078/jrd.2016.23.1.71.

Successful Infliximab Therapy in a Patient with Refractory Takayasu's Arteritis

Affiliations
  • 1Department of Internal Medicine, Seoul Medical Center, Seoul, Korea. atom9752@hanmail.net

Abstract

Takayasu's arteritis (TA), a granulomatous vasculitis, affects the aorta and its major branches. Glucocorticoids are an effective treatment for patients with active TA, but some patients fail to achieve or maintain remission with the conventional therapy, and side effects resulting from long-term glucocorticoid therapy are potentially serious. Anti-tumor necrosis factor-alpha agents, such as infliximab, may be efficient in patients with refractory TA. We report on a 24-year-old female patient with refractory TA who was treated successfully with infliximab. Clinical remission was induced as determined by repeated 18F-fluoro-2-deoxy-D-glucose positron emission tomography scans combined with assay of serological inflammatory markers.

Keyword

Takayasu arteritis; Monoclonal antibodies; Positron-emission tomography

MeSH Terms

Antibodies, Monoclonal
Aorta
Female
Glucocorticoids
Humans
Necrosis
Positron-Emission Tomography
Takayasu Arteritis*
Vasculitis
Young Adult
Infliximab
Antibodies, Monoclonal
Glucocorticoids

Figure

  • Figure 1. Contrast-enhanced computed tomography scan shows diffuse wall thickening (arrows) in (A) aortic arch, and (B) the right brachiocephalic trunk, left common carotid and subclavian arteries.

  • Figure 2. Treatment timeline showing the response of systemic inflammatory markers to glucocorticoid and infliximab during the course of treatment. Erythrocyte sedimentation rate (ESR) denotes erythrocyte sediment rate.

  • Figure 3. (A) Before infliximab treatment; 18 F-Fluoro-2-deoxy-D-glucose (18 F-FDG) positron emission tomography scan shows increased uptake of 18 F-FDG in the aortic arch and bilateral subclavian arteritis (arrowheads; visual grade=3, the number of active vascular lesions=5). (B) Twelve months after infliximab treatment: decreased uptake of 18 F-FDG is evident in the inflamed arterial walls (visual grade=1, the number of active vascular lesions=0).


Reference

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