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22-09-2023 | Takayasu's Arteriitis | Case Report

Nephrotic syndrome induced by aortic regurgitation with Takayasu arteritis: an autopsy case with long-term clinical follow-up

Authors: Kota Kakeshita, Teruhiko Imamura, Akira Noguchi, Sayaka Murai, Hayato Fujioka, Hidenori Yamazaki, Tsutomu Koike, Koichiro Kinugawa

Published in: CEN Case Reports

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Abstract

Takayasu arteritis is a rare, chronic, and large-vessel vasculitis involving the aorta and its branches in a complex autoimmune reaction. Takayasu arteritis sometimes complicates aortic regurgitation and chronic kidney disease, but rarely accompanies nephrotic syndrome. We had a patient with Takayasu arteritis and concomitant aortic regurgitation. She had nephrotic syndrome that was refractory to immunosuppressive therapy but was promptly improved after surgical aortic valve replacement. In her kidney biopsy, glomeruli had mild mesangial proliferative changes without immune complex deposition. Her proteinuria remained negative until the recurrence of aortic regurgitation due to perivalvular leakage. Seventeen years after the surgery, she died suddenly. In her kidney autopsy, the arteriolar showed severe hyalinosis and the glomerulus showed mesangial proliferative changes with segmental mesangiolysis. Severe aortic regurgitation may have altered renal hemodynamics and caused glomerular lesions, resulting in nephrotic syndrome. We should be aware of the rare but critical comorbidity of nephrotic syndrome in patients with Takayasu arteritis and concomitant aortic regurgitation.
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Metadata
Title
Nephrotic syndrome induced by aortic regurgitation with Takayasu arteritis: an autopsy case with long-term clinical follow-up
Authors
Kota Kakeshita
Teruhiko Imamura
Akira Noguchi
Sayaka Murai
Hayato Fujioka
Hidenori Yamazaki
Tsutomu Koike
Koichiro Kinugawa
Publication date
22-09-2023
Publisher
Springer Nature Singapore
Published in
CEN Case Reports
Electronic ISSN: 2192-4449
DOI
https://doi.org/10.1007/s13730-023-00819-1
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