Cardiology and Cardiovascular Research

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Pakistani Origin Takayasu Arteritis: A Case Report with a Brief Review from Asymptomatic Presentation Till Diagnosis and Clinical Management

Received: Oct. 06, 2023    Accepted: Oct. 23, 2023    Published: Nov. 29, 2023
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Abstract

Takayasu's arteritis is a rare chronic granulomatous vasculitis that primarily affects the aorta and its branches. It is estimated that this disease impacts approximately 2.6 million individuals every year, with a higher prevalence among women in their second or third decade of life. In this case report, we describe the presentation and management of a 22-year-old female patient who initially sought medical attention from a neurologist due to upper and lower back pain. Initially, the patient's symptoms were managed conservatively. However, a few months later, she presented to the medical department with a high-grade fever, syncopal episodes, generalized body aches, and swelling in her right arm. The findings from the computed tomography angiography (CTA) revealed diffuse thickening of the entire thoracic and abdominal aorta's walls, long segment luminal narrowing of the proximal left common carotid artery and left subclavian artery, as well as diffuse thickening of the abdominal aorta's wall. This case highlights the importance of recognizing that Takayasu's arteritis can present in an unusual manner. Early diagnosis and management are crucial steps towards providing appropriate care for patients. Due to the potential involvement of various arterial segments, Takayasu's arteritis can manifest with diverse symptoms and complications. Therefore, clinicians should maintain a high index of suspicion when encountering patients with unexplained symptoms, particularly those involving the aorta and its branches. In conclusion, the presented case emphasizes the need for prompt recognition and intervention in Takayasu's arteritis. By increasing awareness of this rare condition and its atypical presentations, healthcare professionals can ensure timely diagnosis and appropriate management, ultimately improving patient outcomes and quality of life. Further research is warranted to enhance our understanding of this complex disease and optimize its management strategies.

DOI 10.11648/j.ccr.20230704.15
Published in Cardiology and Cardiovascular Research ( Volume 7, Issue 4, December 2023 )
Page(s) 93-96
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Takayasu Arteritis, Autoimmune, Autoimmune in Females, Vascular Disease, Large Vessel, Vasculitis

References
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[2] Takayasu Arteritis. A Study of 32 North American Patients.’ Medicine 64, no. 2 (March 1985): 89–99.
[3] Ishikawa, K. ‘Diagnostic Approach and Proposed Criteria for the Clinical Diagnosis of Takayasu’s Arteriopathy.’ Journal of the American College of Cardiology 12, no. 4 (October 1988): 964–72. https://doi.org/10.1016/0735-1097(88)90462-7.
[4] Johnston, S. L., R. J. Lock, and M. M. Gompels. ‘Takayasu Arteritis: A Review.’ Journal of Clinical Pathology 55, no. 7 (July 2002): 481–86. https://doi.org/10.1136/jcp.55.7.481.
[5] Kerr, G. S., C. W. Hallahan, J. Giordano, R. Y. Leavitt, A. S. Fauci, M. Rottem, and G. S. Hoffman. ‘Takayasu Arteritis.’ Annals of Internal Medicine 120, no. 11 (1 June 1994): 919–29. https://doi.org/10.7326/0003-4819-120-11-199406010-00004.
[6] Koide, K. ‘Takayasu Arteritis in Japan.’ Heart and Vessels. Supplement 7 (1992): 48–54. https://doi.org/10.1007/BF01744544.
[7] Kreidstein, S. H., A. Lytwyn, and E. C. Keystone. ‘Takayasu Arteritis with Acute Interstitial Pneumonia and Coronary Vasculitis: Expanding the Spectrum. Report of a Case.’ Arthritis and Rheumatism 36, no. 8 (August 1993): 1175–78. https://doi.org/10.1002/art.1780360819.
[8] Kubasiewicz, E., W. Rydlewska-Sadowska, and M. Płachecka-Gutowska. ‘[Takayasu syndrome with symptoms of systemic lupus erythematosus and rheumatoid arthritis].’ Reumatologia 15, no. 1 (1977): 73–78.
[9] Lupi-Herrera, E., G. Sánchez-Torres, J. Marcushamer, J. Mispireta, S. Horwitz, and J. E. Vela. ‘Takayasu’s Arteritis. Clinical Study of 107 Cases.’ American Heart Journal 93, no. 1 (January 1977): 94–103. https://doi.org/10.1016/s0002-8703(77)80178-6.
[10] Masuda, Hideki, Ukimoto Ishii, Nobuhiko Aoki, Hisashi Nakayama, Fumii Sato, Hideaki Karube, Shigeru Suzuki, and Toshihiko Kondo. ‘Ulcerative Colitis Associated with Takayasu’s Disease in Two Patients Who Received Proctocolectomy.’ Journal of Gastroenterology 37, no. 4 (2002): 297–302. https://doi.org/10.1007/s005350200039.
[11] Meneghetti, M. L., J. Vásquez, D. Alvarado, M. Conde, and G. Sánchez Torres. ‘[Takayasu arteritis: usefulness of radiologic and angiographic studies].’ Archivos del Instituto de Cardiologia de Mexico 59, no. 4 (August 1989): 405–14.
[12] Nakao, K., M. Ikeda, S. Kimata, H. Niitani, and M. Niyahara. ‘Takayasu’s Arteritis. Clinical Report of Eighty-Four Cases and Immunological Studies of Seven Cases.’ Circulation 35, no. 6 (June 1967): 1141–55. https://doi.org/10.1161/01.cir.35.6.1141.
[13] Numano, F. ‘Differences in Clinical Presentation and Outcome in Different Countries for Takayasu’s Arteritis.’ Current Opinion in Rheumatology 9, no. 1 (January 1997): 12–15. https://doi.org/10.1097/00002281-199701000-00003.
[14] Rath, P. C., G. Lakshmi, and Michel Henry. ‘Percutaneous Transluminal Angioplasty Using a Cutting Balloon for Stenosis of the Arch Vessels in Aortoarteritis.’ Indian Heart Journal 56, no. 1 (February 2004): 54–57.
[15] Sharma, B. K., S. Jain, and S. Sagar. ‘Systemic Manifestations of Takayasu Arteritis: The Expanding Spectrum.’ International Journal of Cardiology 54 Suppl (August 1996): S149-154. https://doi.org/10.1016/s0167-5273(96)88784-5.
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[17] Zheng, D., D. Fan, and L. Liu. ‘Takayasu Arteritis in China: A Report of 530 Cases.’ Heart and Vessels. Supplement 7 (1992): 32–36. https://doi.org/10.1007/BF01744541.
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    Ahmad, S., Sajjad Ali Khan, M., Bahadori, P., Khan, A., Ahmad, W., et al. (2023). Pakistani Origin Takayasu Arteritis: A Case Report with a Brief Review from Asymptomatic Presentation Till Diagnosis and Clinical Management. Cardiology and Cardiovascular Research, 7(4), 93-96. https://doi.org/10.11648/j.ccr.20230704.15

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    ACS Style

    Ahmad, S.; Sajjad Ali Khan, M.; Bahadori, P.; Khan, A.; Ahmad, W., et al. Pakistani Origin Takayasu Arteritis: A Case Report with a Brief Review from Asymptomatic Presentation Till Diagnosis and Clinical Management. Cardiol. Cardiovasc. Res. 2023, 7(4), 93-96. doi: 10.11648/j.ccr.20230704.15

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    AMA Style

    Ahmad S, Sajjad Ali Khan M, Bahadori P, Khan A, Ahmad W, et al. Pakistani Origin Takayasu Arteritis: A Case Report with a Brief Review from Asymptomatic Presentation Till Diagnosis and Clinical Management. Cardiol Cardiovasc Res. 2023;7(4):93-96. doi: 10.11648/j.ccr.20230704.15

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  • @article{10.11648/j.ccr.20230704.15,
      author = {Shahzad Ahmad and Muhammad Sajjad Ali Khan and Pardis Bahadori and Aimal Khan and Wiqar Ahmad and Muhammad Ilyas and Komal Qayyum and Muhammad Saeed and Musa Bin Bashir},
      title = {Pakistani Origin Takayasu Arteritis: A Case Report with a Brief Review from Asymptomatic Presentation Till Diagnosis and Clinical Management},
      journal = {Cardiology and Cardiovascular Research},
      volume = {7},
      number = {4},
      pages = {93-96},
      doi = {10.11648/j.ccr.20230704.15},
      url = {https://doi.org/10.11648/j.ccr.20230704.15},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ccr.20230704.15},
      abstract = {Takayasu's arteritis is a rare chronic granulomatous vasculitis that primarily affects the aorta and its branches. It is estimated that this disease impacts approximately 2.6 million individuals every year, with a higher prevalence among women in their second or third decade of life. In this case report, we describe the presentation and management of a 22-year-old female patient who initially sought medical attention from a neurologist due to upper and lower back pain. Initially, the patient's symptoms were managed conservatively. However, a few months later, she presented to the medical department with a high-grade fever, syncopal episodes, generalized body aches, and swelling in her right arm. The findings from the computed tomography angiography (CTA) revealed diffuse thickening of the entire thoracic and abdominal aorta's walls, long segment luminal narrowing of the proximal left common carotid artery and left subclavian artery, as well as diffuse thickening of the abdominal aorta's wall. This case highlights the importance of recognizing that Takayasu's arteritis can present in an unusual manner. Early diagnosis and management are crucial steps towards providing appropriate care for patients. Due to the potential involvement of various arterial segments, Takayasu's arteritis can manifest with diverse symptoms and complications. Therefore, clinicians should maintain a high index of suspicion when encountering patients with unexplained symptoms, particularly those involving the aorta and its branches. In conclusion, the presented case emphasizes the need for prompt recognition and intervention in Takayasu's arteritis. By increasing awareness of this rare condition and its atypical presentations, healthcare professionals can ensure timely diagnosis and appropriate management, ultimately improving patient outcomes and quality of life. Further research is warranted to enhance our understanding of this complex disease and optimize its management strategies.
    },
     year = {2023}
    }
    

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    AU  - Shahzad Ahmad
    AU  - Muhammad Sajjad Ali Khan
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    AU  - Komal Qayyum
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    AU  - Musa Bin Bashir
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    JF  - Cardiology and Cardiovascular Research
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    PB  - Science Publishing Group
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    AB  - Takayasu's arteritis is a rare chronic granulomatous vasculitis that primarily affects the aorta and its branches. It is estimated that this disease impacts approximately 2.6 million individuals every year, with a higher prevalence among women in their second or third decade of life. In this case report, we describe the presentation and management of a 22-year-old female patient who initially sought medical attention from a neurologist due to upper and lower back pain. Initially, the patient's symptoms were managed conservatively. However, a few months later, she presented to the medical department with a high-grade fever, syncopal episodes, generalized body aches, and swelling in her right arm. The findings from the computed tomography angiography (CTA) revealed diffuse thickening of the entire thoracic and abdominal aorta's walls, long segment luminal narrowing of the proximal left common carotid artery and left subclavian artery, as well as diffuse thickening of the abdominal aorta's wall. This case highlights the importance of recognizing that Takayasu's arteritis can present in an unusual manner. Early diagnosis and management are crucial steps towards providing appropriate care for patients. Due to the potential involvement of various arterial segments, Takayasu's arteritis can manifest with diverse symptoms and complications. Therefore, clinicians should maintain a high index of suspicion when encountering patients with unexplained symptoms, particularly those involving the aorta and its branches. In conclusion, the presented case emphasizes the need for prompt recognition and intervention in Takayasu's arteritis. By increasing awareness of this rare condition and its atypical presentations, healthcare professionals can ensure timely diagnosis and appropriate management, ultimately improving patient outcomes and quality of life. Further research is warranted to enhance our understanding of this complex disease and optimize its management strategies.
    
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Author Information
  • General Medicine and HDU/ICU Department, Northwest General Hospital and Research Center, Peshawar, Pakistan

  • General Medicine and HDU/ICU Department, Northwest General Hospital and Research Center, Peshawar, Pakistan

  • School of Medicine, Xi'an Jiaotong University, Xi'an, China

  • General Medicine and HDU/ICU Department, Northwest General Hospital and Research Center, Peshawar, Pakistan

  • General Medicine and HDU/ICU Department, Northwest General Hospital and Research Center, Peshawar, Pakistan

  • General Medicine and HDU/ICU Department, Northwest General Hospital and Research Center, Peshawar, Pakistan

  • General Medicine and HDU/ICU Department, Northwest General Hospital and Research Center, Peshawar, Pakistan

  • Department of Internal Medicine, Al Hussain Medical Service, Sargodha, Pakistan

  • Department of Cardiology, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China

  • Section