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Proteus Takayasu's arteritis with unusual intracranial granulomatosis as initial manifestation

Yu Qiang Chen1, Yuan Wang, Feng Wang

  • 1Department of Nephrology and Rheumatology, Sixth People's Hospital Shanghai, Jiao Tong University, 600 Yishan Road, 200233 Shanghai, China.

Rheumatology International
|April 1, 2010
PubMed

Insights

Takayasu's arteritis, a rare large artery vasculitis, can mimic other conditions. This case highlights unusual intracranial and abdominal aortic aneurysm presentations, expanding diagnostic considerations for this disease.

Area of Science:

  • Vascular Medicine
  • Rheumatology
  • Immunology

Background:

  • Takayasu's arteritis (TA) is a rare, chronic inflammatory condition affecting the aorta and its major branches.
  • Its low incidence and varied presentations can lead to diagnostic challenges, often confused with other vasculitides like polyarteritis nodosa.
  • Early recognition is crucial for effective management and preventing severe complications.

Observation:

  • A 26-year-old male presented with initial symptoms suggestive of intracranial granulomatosis.
  • Subsequent investigations revealed saccular aneurysms in the abdominal aorta, specifically between the celiac trunk and common hepatic artery.
  • The patient exhibited numerous other protean manifestations, adding complexity to the clinical picture.

Findings:

  • The case underscores the diverse and sometimes atypical manifestations of Takayasu's arteritis.
  • Intracranial involvement and abdominal aortic aneurysms, particularly saccular types in this location, are seldom described in TA.
  • The constellation of symptoms presented a diagnostic enigma, initially misdirecting from a primary diagnosis of TA.

Implications:

  • This report expands the spectrum of known Takayasu's arteritis presentations.
  • It emphasizes the importance of considering TA even in the absence of classic "big artery" involvement.
  • Clinicians should maintain a high index of suspicion for TA in young adults with unexplained inflammatory and vascular abnormalities, including intracranial and complex aortic aneurysms.

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