{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:12:37Z","timestamp":1772169157418,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.15837.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000}}],"reference-count":21,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Wellcome Trust","award":["106680"],"award-info":[{"award-number":["106680"]}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>Takayasu arteritis is a rare systemic large vessel vasculitis affecting the aorta and its branches. Sarcoidosis, too, is an inflammatory disease. Both entities are granulomatous conditions with a questionable association in their etiopathogenesis. Only a few cases of their coexistence have been reported in the literature. To our knowledge, no such cases have been reported from Nepal. We report a Nepalese woman who presented with non-productive cough, progressive shortness of breath and chest tightness of 3 years duration. She had a history of recurrent bilateral granulomatous uveitis over the previous 3 years. Examination revealed clubbing of digits, absent pulses over the left radial, ulnar and brachial arteries, and a weak pulse over the right arm including the bilateral carotid arteries. Pulmonary function test showed restrictive pattern, a high-resolution computed tomography (HRCT) scan of the chest revealed findings suggestive of pulmonary sarcoidosis. A CT angiogram suggested large vessel vasculitis. Bronchoscopy with biopsy revealed granulomatous inflammation, negative for malignancy and tuberculosis. She was hence, diagnosed with co-existing Takayasu arteritis and sarcoidosis, and treated with Prednisolone 60 mg once daily with dramatic improvement over 4 days and was discharged stable on domiciliary oxygen. She is currently on azathioprine 50 mg, prednisolone 10 mg without the need for supplemental oxygen.\u00a0This case report highlights the importance of a proper physical examination as a guide to the use of modern technology in making a correct diagnosis. Furthermore, in countries where tuberculosis is endemic, it should always come as the most important differential diagnosis of granulomatous inflammation.<\/ns4:p>","DOI":"10.12688\/wellcomeopenres.15837.2","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T09:35:29Z","timestamp":1595496929000},"page":"73","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: Co-existence of sarcoidosis and Takayasu arteritis"],"prefix":"10.12688","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8264-1394","authenticated-orcid":false,"given":"Jiwan","family":"Poudel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6946-1847","authenticated-orcid":false,"given":"Ujjwol","family":"Risal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keshav Raj","family":"Sigdel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5119-4082","authenticated-orcid":false,"given":"Buddhi Prasad","family":"Paudyal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2659-3425","authenticated-orcid":false,"given":"Sudeep","family":"Adhikari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-2743","authenticated-orcid":false,"given":"Buddha","family":"Basnyat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"1111-8","DOI":"10.1016\/S0140-6736(03)12888-7","article-title":"Sarcoidosis.","volume":"361","author":"R Baughman","year":"2003","journal-title":"Lancet."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"736-55","DOI":"10.1164\/ajrccm.160.2.ats4-99","article-title":"Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999.","volume":"160","year":"1999","journal-title":"Am J Respir Crit Care Med."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"1-11","DOI":"10.1002\/art.37715","article-title":"2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides.","volume":"65","author":"J Jennette","year":"2013","journal-title":"Arthritis Rheum."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"546-50","DOI":"10.1111\/j.1440-1827.2011.02703.x","article-title":"Sarcoidosis with pulmonary hypertension exacerbated by Takayasu-like large vessel vasculitis.","volume":"61","author":"A Ishii","year":"2011","journal-title":"Pathol Int."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"740-745","DOI":"10.1111\/1756-185X.13137","article-title":"Sarcoidosis with Takayasu arteritis: a model of overlapping granulomatosis. A report of seven cases and literature review.","volume":"21","author":"C Chapelon-Abric","year":"2018","journal-title":"Int J Rheum Dis."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/1755-7682-4-9","article-title":"Co-existing sarcoidosis and Takayasu arteritis: report of a case.","volume":"4","author":"A Hamzaoui","year":"2011","journal-title":"Int Arch Med."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"850-3","DOI":"10.1136\/ard.59.11.850","article-title":"Concurrence of sarcoidosis and aortitis: case report and review of the literature.","volume":"59","author":"V Weiler","year":"2000","journal-title":"Ann Rheum Dis."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"A1247","DOI":"10.1016\/j.chest.2019.08.1124","article-title":"Coexistent Takayasu Arteritis and Sarcoidosis: A case report.","volume":"156","author":"B Saha","year":"2019","journal-title":"Chest."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"255-8","DOI":"10.1016\/j.pneumo.2015.10.002","article-title":"[Association of sarcoidosis and Takayasu's disease: A case report].","volume":"72","author":"A Rhanim","year":"2016","journal-title":"Rev Pneumol Clin."},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"487-90","DOI":"10.3348\/jksr.2011.65.5.487","article-title":"Takayasu Arteritis Associated with Sarcoidosis: A Case Report.","volume":"65","author":"M Im","year":"2011","journal-title":"J Korean Soc Radiol."},{"key":"ref-11","doi-asserted-by":"publisher","first-page":"816-9","DOI":"10.1016\/j.revmed.2005.05.018","article-title":"[Association of sarcoidosis and Takayasu's arteritis: an additional case report].","volume":"26","author":"S Robaday","year":"2005","journal-title":"Rev Med Interne."},{"key":"ref-12","doi-asserted-by":"publisher","first-page":"1885-9","DOI":"10.1164\/ajrccm.164.10.2104046","article-title":"Clinical characteristics of patients in a case control study of sarcoidosis.","volume":"164","author":"R Baughman","year":"2001","journal-title":"Am J Respir Crit Care Med."},{"key":"ref-13","doi-asserted-by":"publisher","first-page":"3-6","DOI":"10.1159\/000083392","article-title":"Unusual presentation of sarcoidosis.","volume":"72","author":"G Rizzato","year":"2005","journal-title":"Respiration."},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"545-61","DOI":"10.1097\/MCP.0b013e3283642a7a","article-title":"Multinational evidence-based World Association of Sarcoidosis and Other Granulomatous Disorders recommendations for the use of methotrexate in sarcoidosis: integrating systematic literature research and expert opinion of sarcoidologists worldwide.","volume":"19","author":"J Cremer","year":"2013","journal-title":"Curr Opin Pulm Med."},{"key":"ref-15","doi-asserted-by":"publisher","first-page":"805-12","DOI":"10.1378\/chest.12-1728","article-title":"Methotrexate vs azathioprine in second-line therapy of sarcoidosis.","volume":"144","author":"A Vorselaars","year":"2013","journal-title":"Chest."},{"key":"ref-16","doi-asserted-by":"publisher","first-page":"1145-50","DOI":"10.1183\/09031936.00195010","article-title":"Effectiveness and safety of leflunomide for pulmonary and extrapulmonary sarcoidosis.","volume":"38","author":"D Sahoo","year":"2011","journal-title":"Eur Respir J."},{"key":"ref-17","doi-asserted-by":"publisher","first-page":"67-75","DOI":"10.1097\/CPM.0000000000000136","article-title":"Refractory pulmonary sarcoidosis - proposal of a definition and recommendations for the diagnostic and therapeutic approach.","volume":"23","author":"P Korsten","year":"2016","journal-title":"Clin Pulm Med."},{"key":"ref-18","doi-asserted-by":"publisher","first-page":"1129-1134","DOI":"10.1002\/art.1780330811","article-title":"The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis.","volume":"33","author":"W Arend","year":"1990","journal-title":"Arthritis Rheum."},{"key":"ref-19","doi-asserted-by":"publisher","first-page":"e0154716","DOI":"10.1371\/journal.pone.0154716","article-title":"Immunological Evidence for the Role of Mycobacteria in Sarcoidosis: A Meta-Analysis.","volume":"11","author":"C Fang","year":"2016","journal-title":"PLoS One."},{"key":"ref-20","doi-asserted-by":"publisher","first-page":"49-55","DOI":"10.1016\/0167-5273(96)02660-5","article-title":"Takayasu\u2019s arteritis: role of Mycobacterium tuberculosis and its 65 kDa heat shock protein.","volume":"55","author":"A Aggarwal","year":"1996","journal-title":"Int J Cardiol."},{"key":"ref-21","doi-asserted-by":"publisher","first-page":"547-53","DOI":"10.1111\/j.1365-2249.2004.02644.x","article-title":"Cellular and humoral immune responses to mycobacterial heat shock protein-65 and its human homologue in Takayasu\u2019s arteritis.","volume":"138","author":"S Kumar Chauhan","year":"2004","journal-title":"Clin Exp Immunol."}],"container-title":["Wellcome Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-73\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-73\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-73\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T05:10:11Z","timestamp":1598418611000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-73\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,23]]},"references-count":21,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.15837.2","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/wellcomeopenres.17770.r40058","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.17770.r40058","asserted-by":"object"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,23]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-73\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.17372.r38723, Varun Dhir, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India, 03 Jun 2020, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-73\/v1#referee-response-38723","order":0,"name":"referee-response-38723","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sudeep Adhikari<\/b>; \n<i>Posted: 21 Jul 2020<\/i>; Thank you sir for the review. We have made changes in the manuscript as per your suggestions. However, the images showing most of the abnormalities clearly could not be retrieved for reporting due to technical issues, and we have acknowledged that in the revised manuscript.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-73\/v2#referee-comment-4275","order":1,"name":"referee-comment-4275","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.17372.r38502, Debashish Danda, Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Vellore, Tamil Nadu, India, 15 Jun 2020, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-73\/v1#referee-response-38502","order":2,"name":"referee-response-38502","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sudeep Adhikari<\/b>; \n<i>Posted: 21 Jul 2020<\/i>; Thank you sir for the review.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-73\/v2#referee-comment-4276","order":3,"name":"referee-comment-4276","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.17770.r40058, Hollis E. Krug, Rheumatology Department, Veterans Affairs Medical Center, Minneapolis, MN, USA, 26 Aug 2020, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-73\/v2#referee-response-40058","order":4,"name":"referee-response-40058","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by the Wellcome Trust [106680]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}