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Published on: February 8, 2019
Takayansu's Arteritis Associated with Anterior Uveitis and Cutaneous Extravascular Necrotizing Granuloma
J H Stone1, H C Nousari, D A Jabs
1Co Director, Johns Hopkins Vasculitis Center, As-sistant Professor of Medicine, Division of Rheumatology (JHS); Resident, Department of Dermatology (HCN); Director, Ocular Immunology Clinic, Professor of Ophthalmology (DAJ); Professor of Medicine, Division of Cardiology (LG), Johns Hopkins University.
Abstract:
We describe a case of Takayasu's arteritis (TA) associated with two unusual complications: 1) granulomatous anterior uveitis, and 2) skin nodules demonstrating a cutaneous extravascular necrotizing granuloma. This is the first report of uveitis attributed to TA and the second report of this skin lesion (associated with a small vessel vasculitis) occurring in this disorder. Although an ocular finding was central to the initial description of TA in 1908, eye abnormalities in this disorder are frequently overshadowed by other consequences of vasculitis in large vessels. In this case, correct interpretation of the skin biopsy findings in the context of the known great vessel abnormalities might have led to a more timely diagnosis of TA. Finally, although TA is the prototype of large vessel vascu-litides, this case illustrates the range in the size of blood vessels involved by this form of arteritis. Once the diagnosis was made, the patient responded promptly to a treatment regimen of prednisone and methotrex-ate.
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