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Rudra Paudel, Luis Chavez, Adriana Abrudescu
(Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, NY, USA)
Med Sci Case Rep 2016; 3:100-103
Takayasu arteritis is a rare form of vasculitis that affects the large blood vessels and can present as constitutional symptoms such as pain, fatigue, weight loss, and low-grade fever. Diagnosis is usually made on clinical evidence rather than imaging/histology. However, diagnosis is easily missed because of low clinical suspicion and cursory physical examination.
CASE REPORT: A 20-year-old woman presented to the Emergency Department (ED) on multiple occasions with complaint of abdominal pain associated with exertion and eating. Her impalpable left radial pulse and un-measurable left BP were missed on prior visits. Further workup revealed findings suggestive of Takayasu arteritis involving the abdominal arteries. She responded well to steroid and methotrexate therapy.
CONCLUSIONS: Takayasu arteritis should be considered as a differential diagnosis in a young patient presenting with abdominal pain and nonspecific symptom like fatigue. Comprehensive history and meticulous physical examination, including the vascular system, are indispensable in diagnosis, timely management, and prevention of complications in this rare condition.