Supplementary Material for: Coincidence of Takayasu arteritis and Multiple Sclerosis - narrative review and case report

Background
Takayasu arteritis (TA) and multiple sclerosis (MS) are both immune-mediated diseases that can coexist, with TA causing vascular inflammation and MS involving demyelination driven by aberrant T-cell activity. The overlap of these conditions highlights shared immune mechanisms, such as T-cell dysregulation and cytokine release, underscoring the need for a nuanced understanding of their interplay, which is explored in a narrative review of reported cases.
Summary
We narrate all reported cases of Takayasu arteritis in patients with multiple sclerosis and report the case of a 57-year-old woman with multiple sclerosis with suspected bilateral optic neuritis and typical contrast-medium enhancement in both optic nerves. Because of normal visual acuity on both eyes, malignant hypertension and fundoscopic findings indicative of hypertensive retinopathy, we diagnosed a hypertensive retinopathy with secondary contrast-medium enhancement of the optic nerves. We established antihypertensive medication and searched for secondary causes of hypertension and highly elevated erythrocyte sedimentation rate, which led to the finding of large vessel wall inflammation and the diagnosis of Takayasu arteritis.
Key Messages
TA can present with a variety of ocular symptoms, including hypertensive retinopathy, retinal ischemia, and anterior ischemic optic neuropathy, often mimicking other diseases.
While rare, the coexistence of TA and MS, including cases associated with interferon-beta therapy, suggests shared immune mechanisms and underscores the need for careful monitoring of patients with MS receiving immunomodulatory treatments.
The broad spectrum of potential causes for optic nerve abnormalities necessitates a thorough evaluation to avoid misdiagnosis and ensure appropriate treatment.

背景
大动脉炎（Takayasu arteritis，TA）与多发性硬化（multiple sclerosis，MS）均为可共存的免疫介导性疾病，其中TA引发血管炎症，而MS则涉及由异常T细胞活性驱动的脱髓鞘病变。这两种疾病的重叠凸显了共同的免疫机制，如T细胞失调和细胞因子释放，强调了对其相互作用进行细致理解的必要性——这一点在已报道病例的叙述性综述中得到探讨。
摘要
我们叙述了所有已报道的多发性硬化患者合并TA的病例，并报告了一例57岁女性MS患者的病例：该患者疑似双侧视神经炎，且双侧视神经均出现典型的造影剂强化。鉴于患者双眼视力正常、存在恶性高血压且眼底检查结果提示高血压性视网膜病变，我们诊断其为高血压性视网膜病变伴视神经继发性造影剂强化。我们启动了降压药物治疗，并排查了高血压及红细胞沉降率显著升高的继发原因，最终发现大血管壁炎症，从而确诊TA。
核心信息
TA可表现为多种眼部症状，包括高血压性视网膜病变、视网膜缺血及前部缺血性视神经病变，且常与其他疾病表现相似。
尽管TA与MS共存的情况较为罕见（包括与β干扰素治疗相关的病例），但这一现象提示两者存在共同的免疫机制，同时强调需对接受免疫调节治疗的MS患者进行密切监测。
视神经异常的潜在病因范围广泛，因此需进行全面评估，以避免误诊并确保治疗的恰当性。