Takayasu arteritis

Case contributed by Mohamed Abdel-Tawab Mohamed
Diagnosis almost certain

Presentation

History of fatigue, diffuse muscle pain and mild fever.

Patient Data

Age: 20 years
Gender: Female
ct

Diffuse mural thickening of the aortic arch and descending aorta. Also, thickening of the arch branches. Mild stenosis of the ostia of caeliac and superior mesenteric arteries with normal prominent caliber beyond their origins.

Severe stenosis of the infrarenal aorta till its bifurcation with marked collaterals in the anterior abdominal wall as well as mesenteric collaterals. The arc of Riolan, which  is an arterio-arterial anastomosis between the superior and inferior mesenteric arteries  is markedly prominent and serves collateral supply to the distal aorta.

Case Discussion

CT angiographic findings suggestive of Takayasu arteritis with severe stenosis occlusion of the infrarenal aorta and extensive collaterals.

Takayasu arteritis is a large vessel vasculitis that predominantly affects the aorta as well as its branches. It has a strong female predilection. Early in disease, the symptoms are vague and non-specific, but later it presents with absent pulse.

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