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1998 Presentations for the Poster and Vignette Sessions
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A CASE OF TAKAYASU'S ARTERITIS. Kate Keshena, MD, Marshfield Clinic/St. Joseph's Hospital, Marshfield, WI

Takayasu's arteritis, also known as aortic arch arteritis or pulseless disease, is a vasculitis which affects large and medium sized arteries. The largest number of cases has been reported in Japan, India and China, primarily in women and children. The incidence of Takayasu's arteritis among Caucasians in Omsted County, MN is 2.6 cases per million per year.

We report on a 43-year-old female who presented to the Marshfield Clinic with the chief complaint of headache and visual changes. The head CT showed peculiar low density defects. A MRI was suggested to differentiate between infection, ischemia or a demylinating process. The MRI showed multiple signal abnormalities and vasculitis was considered in the differential given her history of headache. She was diagnosed with Takayasu's arteritis on the basis of aortic arch arteriogram which is the gold standard study for this diagnosis. The cornerstone of the treatment of Takayasu's arteritis is glucocorticoids in order to suppress symptoms and to stabilize or reverse the stenosis. There is rapid improvement in pulses and the ischemic symptoms resolve if treatment is started before fibrotic tissue is laid down. This patient wasstarted on steroids while awaiting the results of a temporal artery biopsy. The diagnosis of this uncommon disease was facilitated by an understanding of the suggestive characteristics of the MRI together with the clinical presentation.

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