Takayasu arteritis evaluated by multi-slice computed tomography in an old man.

Area of Science:

• Cardiology
• Rheumatology
• Radiology

Background:

• Takayasu arteritis (TA) is a large vessel vasculitis, usually affecting young women, presenting with constitutional symptoms or incidental findings.
• Typical manifestations involve the aorta and its branches, leading to diverse clinical presentations.

Observation:

• An elderly male patient presented with bilateral massive pleural effusion and aortic aneurysm, diagnosed via 64-slice computed tomography (CT).
• This presentation is atypical for Takayasu arteritis, which commonly affects younger demographics.

Findings:

• Steroid therapy demonstrated dose-dependent efficacy in suppressing inflammatory symptoms.
• While pleural effusion resolved, the aortic aneurysm size remained unchanged.
• Multi-slice CT was instrumental in non-invasively detecting unexpected lesions characteristic of TA.

Implications:

• This case expands the known clinical spectrum of Takayasu arteritis, emphasizing its potential presentation in elderly individuals.
• It underscores the diagnostic utility of advanced imaging modalities like multi-slice CT in identifying complex vascular and inflammatory conditions.
• The findings suggest a need for vigilance in considering TA even in atypical patient profiles and highlight the importance of tailored management strategies.