Takayasu's arteritis and chronic autoimmune thyroiditis in a patient with type 1 diabetes mellitus

Takayasu's arteritis is a rare, chronic inflammatory disease of unknown origin, affecting the walls of the aorta and its main branches, as well as coronary and pulmonary arteries. The inflammation of the arteries may lead to stenosis, occlusions, dilatations, and aneurysms of involved vessels. It is relatively common in Asia and the Far East but is rare in the Western Hemisphere. We present the case of a 36-year-old white woman with a history of type 1 diabetes mellitus and chronic autoimmune thyroiditis who complained of easy fatigability in the upper limbs, with absent arterial pulses in the upper limbs and audible bruits over both subclavian and left common carotid arteries. Intra-arterial digital subtraction angiography revealed complete or subtotal obliteration of the aortic arch's branches, with the brain supplied with blood only by the left vertebral artery originating directly from the aortic arch. We diagnosed Takayasu's arteritis with abnormal origin of the left vertebral artery. To the best of our knowledge, our case of Takayasu's arteritis and chronic autoimmune thyroiditis in a type 1 diabetic patient with abnormal origin of the left vertebral artery is the first one ever described.