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      Stroke as the Sole Manifestation of Takayasu Arteritis in a 15-Year-Old Boy with Latent Tuberculosis

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          Abstract

          Introduction. Takayasu arteritis is a rare disease affecting the aorta and its main branches, causing arterial claudication and end-organ ischemia, including stroke. The etiology is unknown but is believed to be autoimmune. An association between Takayasu arteritis and tuberculosis has been suggested, but the possible relation is unclear. Case Presentation. A 15-year-old Somali boy was diagnosed with latent tuberculosis. He had a lesion in the right lung, and both the tuberculin skin test by the Mantoux method and Quantiferon GOLD test turned out positive. After he suffered a cerebral infarct in the right hemisphere, childhood Takayasu arteritis was diagnosed. The diagnosis was based on diagnostic imaging showing a high-grade stenosis of the origin of the right common carotid artery, an occluded common carotid artery on the left side, a circumferential thickening of the vessel walls in the right and left common carotid artery, and laboratory findings with elevated C-reactive protein. Conclusion. Takayasu arteritis is an uncommon cause of stroke. It should however be kept in mind as a cause of cerebrovascular disease, especially in the young.

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          EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria.

          To validate the previously proposed classification criteria for Henoch-Schönlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA). Step 1: retrospective/prospective web-data collection for children with HSP, c-PAN, c-WG and c-TA with age at diagnosis
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            Angiographic findings of Takayasu arteritis: new classification.

            Having proposed a new classification on angiographic findings of patients with Takayasu arteritis, we evaluated the angiographic findings of 80 Japanese patients and 102 Indian patients according to this classification. Japanese patients showed a higher frequency of involvement of the ascending aorta, aortic arch and its branches than did the Indians (P < 0.01). On the other hand, the frequency of involvement of the abdominal aorta and/or renal arteries was higher in Indian patients (P < 0.01). Type III cases of the new classification which involves the thoracic descending aorta, abdominal aorta and/or renal arteries were observed in 3% of the Indian patients, but not at all in the Japanese. In conclusion, in Japanese patients, vascular lesions tend to occur primarily in the ascending aorta, aortic arch and/or its branches and extend into the abdominal aorta. On the other hand, in Indian patients, the tendency is primarily in the abdominal aorta including renal arteries and extending into the thoracic aorta.
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              The epidemiology of Takayasu arteritis in the UK.

              Takayasu arteritis (TAK) is a large-vessel vasculitis of unknown aetiology. The annual incidence in hospital-based studies is 1-2/million. The UK General Practice Research Database (UKGPRD) contains complete primary care records on 3.6 million people. There are no data on the incidence of TAK in the UK or from primary care anywhere in the world. The aim of this study was to determine the annual incidence of TAK in the UK using the UKGPRD and in a well-defined hospital population [Norfolk Vasculitis Register (NORVASC)]. We identified all patients in the UKGPRD with a first diagnosis of TAK during 2000-05, using the Read code (G757); and in the NORVASC population. The annual incidence was calculated as the number of incident cases divided by total person-years. A total of 14 (13 females) subjects were identified with a first diagnosis of TAK during 2000-05 in the UKGPRD. The median age was 51.0 years (interquartile range 28-66). The overall annual incidence of TAK was 0.8/million (95% CI 0.4, 1.3). The incidence was stable throughout the study period. The mean prevalence of TAK was 4.7/million. There were six patients (five females) aged <40 years presenting in 2000-05 with TAK. The annual incidence in those aged <40 years was 0.3/million. In the NORVASC population, one case was identified (0.4/million/year) with three prevalent cases (7.1/million). This is the first population-based study of the epidemiology of TAK. The annual incidence and prevalence are consistent with previous studies.
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                Author and article information

                Journal
                Case Rep Neurol Med
                Case Rep Neurol Med
                CRINM
                Case Reports in Neurological Medicine
                Hindawi Publishing Corporation
                2090-6668
                2090-6676
                2016
                14 November 2016
                : 2016
                : 8736248
                Affiliations
                1Department of Neurology, Nordland Hospital, Bodø, Norway
                2Division of Internal Medicine, Nordland Hospital, Bodø, Norway
                3Department of Radiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
                4Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
                5Department of Clinical Medicine, The Arctic University of Tromsø (UiT), Tromsø, Norway
                Author notes

                Academic Editor: Massimiliano Filosto

                Author information
                http://orcid.org/0000-0002-7450-9534
                Article
                10.1155/2016/8736248
                5124653
                27965905
                a81a0d14-d6e3-4b13-90eb-dde087b896cc
                Copyright © 2016 Espen Benjaminsen et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 June 2016
                : 18 October 2016
                : 1 November 2016
                Categories
                Case Report

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