A Rare Case of Homocysteinemia Presenting With Multiple Aneurysms in an Adolescent Boy

Abstract

Thoracoabdominal aortic aneurysm (TAAA) is primarily a disorder of the elderly; the condition, however, is rare in children, for whom the misdiagnosis is not uncommon. It is one of the leading causes of death in the older age group worldwide, with a 4:1 male to female ratio. There are no real data about the incidence of aortic aneurysms in childhood. Although rare, an aortic aneurysm can be an important cause of mortality in children and adolescents. We present a case of an adolescent boy with a left coronary artery aneurysm, left axillary artery aneurysm, and TAAA type-IV caused by the metabolic disease homocysteinemia. He was referred to our facility when the complicated picture of the disease was discovered.

Keywords: aneurysm; aorta; atherosclerosis; pulsatile; thoracoabdominal.

Figure 1. 3D constructed view of CT angiogram showing thoracoabdominal aortic aneurysm involving both common iliac veins (blue arrows) and eccentric saccular outpouching of the pararenal part (green arrows)

Figure 2. CT angiogram axial view showing the pararenal component of the aneurysm to the largest size. The left renal artery is not visible and the left kidney is also pushed down by the aneurysm (shown by blue arrows)