Journal of Rafsanjan University of Medical Sciences
مجله دانشگاه علوم پزشکی رفسنجان
JRUMS
Medical Sciences
http://journal.rums.ac.ir
69
journal69
1735-3165
2008-7268
10.66224/jrums
fa
jalali
1404
8
1
gregorian
2025
11
1
24
8
online
1
fulltext
fa
گزارش یک مورد نادر درگیری شریان براکیال و انسداد شریان سابکلاوین در بیمار مبتلا به آرتریت تاکایاسو
A Rare Case Report of Brachial Artery Involvement and Subclavian Artery Occlusion in a Patient with Takayasu Arteritis
روماتولوژي
Romathology
گزارش مورد
Case Report
<span style="font-size:10pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="AR-SA" style="font-size:11.5pt"><span style="font-family:"B Nazanin"">چکیده</span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:"Times New Roman",serif"><a name="_Hlk113374001"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">مقدمه: </span></span></span></b></a><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">آرتریت تاکایاسو یک واسکولیت سیستمیک نادر است که درگیری شریان براکیال را میتوان یافتهای غیرمعمول در نظر گرفت.</span></span></span><b><span dir="LTR" style="font-size:12.0pt"><span style="line-height:107%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:"Times New Roman",serif"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">گزارش مورد: </span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">بیمار یک زن </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">۲۵</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin""> ساله، ورزشکار و بدون سابقه بیماری خاص بود که با درد بین دوکتف، پارستزی و ضعف در اندام فوقانی چپ مراجعه نمود. در معاینه، نبض و فشارخون اندام چپ قابل اندازهگیری نبود. </span></span></span><span dir="LTR" style="line-height:107%">ESR</span> <span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">بیمار </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">۹۵</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin""> میلیمتر بر ساعت بود. تصویربرداری به روش سیتی آنژیوگرافی، انسداد کامل شریان سابکلاوین چپ و درگیری نادر شریان براکیال را نشان داد. با توجه به معیارهای تشخیصی، آرتریت تاکایاسو نوع </span></span></span><span dir="LTR" style="line-height:107%">I</span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin""> تأیید شد.</span></span></span><b><span dir="LTR" style="font-size:12.0pt"><span style="line-height:107%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:"Times New Roman",serif"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">نتیجهگیری: </span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">بهدلیل سن پایین بیمار و ملاحظات باروری، درمان با پالس متیلپردنیزولون آغاز و سپس رژیم دارویی به مایکوفنولات موفتیل و پردنیزولون تغییر یافت. پس از چهار هفته، علائم بالینی بیمار بهبود یافت، اگرچه نبض اندام درگیر هنوز لمس نمیشد. این مورد، اهمیت درنظرگیری بیماریهای روماتولوژیک مانند تاکایاسو را در زنان جوان با علائم اسکلتی-عروقی غیرمعمول و ضرورت درمان بهموقع برای جلوگیری از عوارض دائمی برجسته میسازد.</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:"Times New Roman",serif"><v:roundrect arcsize="0" id="Rounded_x0020_Rectangle_x0020_9" o:gfxdata="UEsDBBQABgAIAAAAIQC75UiUBQEAAB4CAAATAAAAW0NvbnRlbnRfVHlwZXNdLnhtbKSRvU7DMBSF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==
" style="position:absolute; left:0; text-align:left; margin-left:-6px; margin-top:30px; width:490.65pt; height:46.05pt; z-index:-251653632; v-text-anchor:top"> <w:wrap anchorx="margin"> </w:wrap></v:roundrect><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">واژههای کلیدی</span></span></span></b><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin"">:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:107%"><span style="font-family:"B Nazanin""> آرتریت تاکایاسو، شریان براکیال، شریان ساکلاوین</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:1.0pt"><span style="line-height:120%"><span style="font-family:"B Nazanin""></span></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:1.0pt"><span style="line-height:120%"><span style="font-family:"B Nazanin""></span></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:120%"><span style="font-family:"B Nazanin"">ارجاع:</span></span></span></b> <span lang="FA" style="font-size:12.0pt"><span style="line-height:120%"><span style="font-family:"B Nazanin"">شاکرمیامیرحسین ، فضائلی عر. گزارش یک مورد نادر درگیری شریانبراکیال و انسداد شریان سابکلاوین در بیمار مبتلا به آرتریت تاکایاسو. <i>مجله دانشگاه علوم پزشکی رفسنجان</i>، سال 1404، دوره 24، شماره 8، صفحات: </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:120%"><span style="font-family:"B Nazanin"">766-759.</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><a name="_Hlk114425361"><b><span style="font-size:9.0pt"><span style="line-height:120%">Background and Objectives: </span></span></b></a><span style="font-size:9.0pt"><span style="line-height:120%">Takayasu arteritis is a rare systemic vasculitis, and involvement of the brachial artery can be considered an unusual finding.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Case Report:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> A 25-year-old female athlete with no remarkable past medical history presented with interscapular pain, paresthesia, and weakness of the left upper limb. Physical examination revealed absent pulse and unrecordable blood pressure in the left arm. The erythrocyte sedimentation rate (ESR) was elevated at 95 mm/hour. Computed tomography angiography demonstrated complete occlusion of the left subclavian artery along with the uncommon involvement of the brachial artery. According to the diagnostic criteria, Type I Takayasu arteritis was confirmed.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Conclusion:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> Due to the patient’s young age and fertility considerations, treatment was initiated with methylprednisolone pulse therapy, followed by a maintenance regimen of mycophenolate mofetil and prednisolone. After four weeks, the patient’s clinical symptoms improved, although the pulse in the affected limb remained impalpable. This case highlights the importance of considering rheumatologic diseases such as Takayasu arteritis in young women presenting with atypical musculoskeletal or vascular symptoms, as well as the necessity of timely treatment to prevent permanent complications.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Keywords:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> Takayasu arteritis, Brachial artery, Subclavian artery</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><span dir="RTL" lang="AR-SA" style="font-size:5.0pt"><span style="line-height:120%"></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Conflict of Interest:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> None declared.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Funding:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> This research received no specific grant from any funding agency.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Ethical considerations: </span></span></b><span style="font-size:9.0pt"><span style="line-height:120%">This report was prepared to advance medical knowledge and share a valuable educational case. Respect for patient privacy, human dignity, and confidentiality formed the foundation throughout all stages of writing and publication. The authors acknowledge that due to the retrospective nature of case reports (often compiled post-treatment without prior publication plans), obtaining a formal ethics code before drafting was not feasible. Nevertheless, our commitment to upholding the highest ethical standards in protecting patient privacy remains fundamental and non-negotiable.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Author’s contributions:</span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Conceptualization:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> Alireza Fazaeli</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Methodology:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> Amirhossein Shakarmi</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Data collection: </span></span></b><span style="font-size:9.0pt"><span style="line-height:120%">Amirhossein Shakarmi</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Formal analysis:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> Alireza Fazaeli</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Supervision: </span></span></b><span style="font-size:9.0pt"><span style="line-height:120%">Alireza Fazaeli</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Project administration:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> Alireza Fazaeli</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Writing – original draft:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> Amirhossein Shakarmi</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:120%">Writing – review & editing:</span></span></b><span style="font-size:9.0pt"><span style="line-height:120%"> Amirhossein Shakarmi</span></span><span style="font-size:9.0pt"><span style="line-height:120%"></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:135%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><v:roundrect arcsize="0" id="Rounded_x0020_Rectangle_x0020_6" o:gfxdata="UEsDBBQABgAIAAAAIQC75UiUBQEAAB4CAAATAAAAW0NvbnRlbnRfVHlwZXNdLnhtbKSRvU7DMBSF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" style="position:absolute; left:0; text-align:left; margin-left:5px; margin-top:2px; width:496.3pt; height:34.95pt; z-index:251664896; v-text-anchor:top"> <v:textbox>
<table width="100%">
<tbody>
<tr>
<td>
<div><span style="font-size:10pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:8.0pt"><span style="line-height:150%">Citation:</span></span></b> <span style="font-size:8.0pt"><span style="line-height:150%">Shakarami AH, Fazaeli AR. A Rare Case Report of Brachial Artery Involvement and Subclavian Artery Occlusion in a Patient with Takayasu Arteritis</span></span><span style="font-size:8.0pt"><span style="line-height:150%">. <i>J Rafsanjan</i> <i>Univ Med Sci</i> 2025; 24 (8): 759-66. [Farsi]</span></span><span style="font-size:8.0pt"><span style="line-height:150%"></span></span></span></span></span></div>
</td>
</tr>
</tbody>
</table>
</v:textbox> <w:wrap anchorx="margin"> </w:wrap></v:roundrect><span style="font-size:9.0pt"><span style="line-height:135%"></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:135%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><span style="font-size:9.0pt"><span style="line-height:135%"></span></span></span></span></span></span></span><br>
آرتریت تاکایاسو, شریان براکیال, شریان ساکلاوین
Takayasu arteritis, Brachial artery, Subclavian artery
759
766
http://journal.rums.ac.ir/browse.php?a_code=A-10-7088-1&slc_lang=fa&sid=1
Amir hossein
Shakarami
امیرحسین
شاکرمی
Amirhosseinshakarami4@gmail.com
6900319475328460061850
0009-0000-6836-3762
No
medical science of Hamedan
علوم پزشکی همدان
Aliraza
Fazaeli
علیرضا
فضائلی
Bahrolfazael@yahoo.com
6900319475328460061851
6900319475328460061851
Yes
medical science of Hamedan
علوم پزشکی همدان