Takayasu Arteritis

Abstract

A 31-year-old woman was admitted because of hypertension. She often had unexplained fever and had taken tranquilizers due to general malaise, with little effect, for a few months before admission. The symptoms had gradually improved and completely disappeared 2 months earlier. On admission, her blood pressure was 183/85 mmHg, but the remainder of the examination was normal. Carotid ultrasound showed diffuse, homogeneous wall thickening of the bilateral common carotid arteries (Picture A, long-axis; Picture B, short-axis), known as the "macaroni sign" (1, 2). The diagnosis of renovascular hypertension due to Takayasu arteritis was finally made. Takayasu arteritis is a chronic inflammatory vasculitis characterized by stenosis or obliteration of the aorta and its major branches predominantly in young women. Corticosteroid was not administered because of the lack of inflammatory signs. The blood pressure normalized after successful balloon renal angioplasty. She has remained well for over a year, but the macaroni sign has not changed.

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“…TA manifests as constitutional symptoms such as weight loss and anorexia, and progresses to claudication and hypertension caused by pathological vascular narrowing or occlusion. Glucocorticoids are the mainstay of therapy; immunosuppressive agents including MTX and cyclophosphamide play roles as glucocorticoid-sparers [34]. In TA patients, IL-6 is synthesized by activated dendritic cells in the walls of blood vessels, activating CD4+ T cells and inducing the maturation of Th1 and Th17 cells [35].…”