Crohn's disease associated with Takayasu's arteritis

Area of Science:

• Vascular Imaging
• Gastroenterology
• Rheumatology

Background:

• Takayasu's arteritis, a large vessel vasculitis, can present with gastrointestinal symptoms.
• Differentiating Takayasu's arteritis from inflammatory bowel disease is crucial for appropriate management.

Observation:

• Standard roentgenography suggested Crohn's ileocolitis in a young woman with Takayasu's arteritis.
• Mesenteric angiography was performed to further investigate the gastrointestinal findings.

Findings:

• Mesenteric angiography revealed the diagnostic 'zoning sign' in the cecum (hypervascular inner layer, hypovascular outer layer).
• Inflammatory neovasculature adjacent to the ascending colon was observed, indicative of Crohn's disease.
• Nonspecific findings supporting the diagnosis were also demonstrated.

Implications:

• This case highlights the importance of considering Crohn's disease in patients with Takayasu's arteritis presenting with ileocolitis.
• Mesenteric angiography is a valuable tool for diagnosing Crohn's disease, especially when atypical presentations occur.
• Large vessel involvement in inflammatory bowel disease is further exemplified by this case.