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Journal of Pathobiology and Physiology

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Takayasu arteritis: Diagnostic approach

Author(s): Malikul Chair

Takayasu Arteritis (TA) is an immune-mediated vasculitis characterized by a systemic large-vessel vasculitis of unknown etiology that most commonly affects women of childbearing age. This report demonstrates the importance of diagnostic approach in rare case of Takayasu’s arteritis patients. This is a case report presenting a 25-years-old female complained a recurrent left arm pain which worsened when she worked as a doctor. Formerly, she had experienced intermittent bilateral leg pain for four years and audible sound coming from inside her neck and there were blood pressure difference >10 mmHg between arms. There was increased CRP and ESR. CT angiography was then performed and showed multiple stenosis in large arteries including bilateral neck area, shoulder area, abdominal aorta, and right renal artery. The other laboratory data to exclude differential diagnosis are unremarkable. Vasculitis syndromes are classified according to the size of affected vessels, into large-vessel, medium-vessel, and small-vessel vasculitis. Site of affected vessel should be the entry point for making diagnostic approach in vasculitis suspected patient. Takayasu arteritis involves the aorta and its major branches. The diagnosis of TA should be made according to which vessel vasculitis involvement, lesions distribution and disease activity. In this case, the blood vessel involved are large vessel vasculitis which consistent with Takayasu arteritis. Based on angiographic classification of TA, this patient was confirmed as Type-V vessel involvement with active disease activity.


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