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Case Reports
. 2024 Jun 3;12(6):e9051.
doi: 10.1002/ccr3.9051. eCollection 2024 Jun.

Unusual manifestations of Takayasu arteritis: A diagnostic challenge

Tahseen Ali Al-Kinani  1 , Ali Akeel Al-Yacopy  1 , Ahmed Qasim Mohammed Alhatemi  2 , Hashim Talib Hashim  3 , Rand Abdulhussain  4 , Ali Talib Hashim  5
Affiliations
Case Reports

Unusual manifestations of Takayasu arteritis: A diagnostic challenge

Tahseen Ali Al-Kinani et al. Clin Case Rep. .

Abstract

Key clinical message: Timely recognition of atypical Takayasu arteritis is crucial. Unusual presentations, such as pericardial effusion, can complicate diagnosis. CT angiogram aids in precise diagnosis, guiding targeted immunosuppressive therapy. Multidisciplinary collaboration is vital for comprehensive management, improving patient outcomes in this challenging condition.

Abstract: This case study highlights the diagnostic challenges posed by atypical presentations of Takayasu arteritis (TA), focusing on a 42-year-old male presenting with pericardial effusion. Despite inconclusive initial investigations, a CT angiogram revealed large vessel vasculitis, confirming TA. Management with immunosuppressive therapy led to clinical improvement. This case emphasize the importance of recognizing unusual manifestations of TA for timely diagnosis and appropriate treatment, emphasizing the role of multidisciplinary collaboration in optimizing patient outcomes.

Keywords: cardiology; emergency medicine; immunology; radiology and imaging; rheumatology.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Baseline ECG showing multiple PVCs probably from left ventricular outflow tract obstruction LVOT with compensatory pause.
FIGURE 2
FIGURE 2
Chest X‐ray PA view revealing enlarged cardiac shadow.
FIGURE 3
FIGURE 3
(A) Initial transthoracic echocardiogram TTE modified parasternal long axis view showing large pericardial effusion PE. (B) Repeated transthoracic echocardiogram TTE four chamber view revealing no pericardial effusion 1 day after pericardiocentisis.
FIGURE 4
FIGURE 4
(A) CT angiogram of the aorta shows normal contrast filling in the main aortic arch branches with no aneurysm observed. Marked wall thickening is noted at the left common carotid artery (CCA) and left subclavian artery (SCA), with severe stenosis at the origin and proximal segment of the left SCA (white arrows). (B) CT angiogram axial view shows narrow and tapered proximal left SCA with increased aortic arch wall thickness (white arrows). (C) CT angiogram three‐dimensional (3D) view revealing marked wall thickening at the left CCA and left SCA, with severe stenosis at the origin and proximal segment of the left SCA (white arrows). (D) CT angiogram sagittal view shows marked wall thickness with enhancement at the left SCA (white arrow).
FIGURE 5
FIGURE 5
Follow‐up ECG conducted after 6 months, illustrating premature ventricular contractions (PVCs).
See this image and copyright information in PMC

References

    1. Kim ESH, Beckman J. Takayasu arteritis: challenges in diagnosis and management. Heart. 2017;104:558. - PubMed
    1. Mason JC. Takayasu arteritis—advances in diagnosis and management. Nat Rev Rheumatol. 2010;6(7):406‐415. - PubMed
    1. Russo RAG, Katsicas MM. Takayasu arteritis. Front Pediatr. 2018;6:265. - PMC - PubMed
    1. Kerr GS, Hallahan CW, Giordano J, et al. Takayasu arteritis. Ann Intern Med. 1994;120(11):919‐929. - PubMed
    1. Mwipatayi BP, Jeffery PC, Beningfield SJ, et al. Takayasu arteritis: clinical features and management: report of 272 cases. ANZ J Surg. 2005;75(3):110‐117. - PubMed

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