Takayasu arteritis: Case-report and outcome in 23 years

Abstract

ABSTRACT

Takayasu arteritis is a rare chronic idiopathic granulomatous vasculitis that affects the aorta and its main branches, producing arterial hypertension and pulseless alteration. Our goal is to present a patient who was diagnosed at 5 months of age and has been monitored for 23 years, with a positive evolution. In addition, discuss the importance of long-term treatment, besides clinical, laboratory and image monitoring. We present a 23 years-old female patient, who was diagnosed with Takayasu Arteritis at 5 months of age, based on the recommendations of the American Society of Rheumatology: arterial hypertension with difference in systolic pressure between arms, radiological evidence of arterial narrowing in the aorta and its main branches. Takayasu Arteritis is not unfrequent in children and is generally diagnosed in young adults between the second and third decade of age. The evolution is shown from a clinical point of view with images, highlighting the importance of magnetic resonance angiography for the control of arterial stenosis and sonogram for controlling renal growth. We discuss, according to the literature available, ways to follow the illness activity, specially in regard to hemograms and eritrosedimentation rate (ESR). The treatments with steroids and other immunosuppresors like Azathioprine and Metotrexate are analyzed, including the indications and duration of these medications. Surgery is indicated in special cases, such as strokes, arterial occlusion of extremities and severe arterial hypertension.