Takayasu arteritis in an adolescent with Crohn’s disease

Abstract

Crohn’s disease (CD) and Takayasu arteritis (TA) are two distinct clinical entities. Τhe likelihood of both diseases coexisting is low, and although CD co-occurs with all types of vasculitis, TA is the most common subtype. Herein, the case of a 15-year-old female, diagnosed with TA following an initial diagnosis of CD, is reported. A review of the literature, including a systemic review of the case reports and case series of children and adolescents up to the age of 21, with both CD and TA, follows the case description. In total, 28 cases of TA and CD were retrieved. The median age of patients was 14.8 years, they were mostly females (72%) and the median time between the two diagnoses was 3.7 years. In the majority of cases, CD was diagnosed first and TA followed. Computed tomography angiography and magnetic resonance angiography were the preferred imaging modalities to assist diagnosis.

The Retroperitoneal Space

“…Takayasu arteritis is a rare, chronic, granulomatous large-vessel vasculitis (LVV) that affects the aorta and its branches. [7][8][9][10] Patients with suspected LVV should undergo methodological vascular examination (BP evaluation, cardiac auscultation, and systematic search for bruits or abnormal pulses). 8 In the reported TA cases, 2 were female, and this was consistent with past literature as women are more commonly affected.…”

“…[7][8][9][10] Patients with suspected LVV should undergo methodological vascular examination (BP evaluation, cardiac auscultation, and systematic search for bruits or abnormal pulses). 8 In the reported TA cases, 2 were female, and this was consistent with past literature as women are more commonly affected. 10 All TA patients had nonspecific constitutional symptoms at diagnosis (weight loss in all 3, fever and night sweats in 1), usually present in 8% of LVV cases, according to large cohort studies.…”

“…10 All TA patients had nonspecific constitutional symptoms at diagnosis (weight loss in all 3, fever and night sweats in 1), usually present in 8% of LVV cases, according to large cohort studies. 8 Abdominal pain (suggesting abdominal aorta claudication) was present in 2 patients, and studies show that almost 50% of LVV patients will present with vascular-related symptoms. 8 Moreover, carotid and abdominal murmurs were discovered in all patients on direct physical examination.…”

“…8 Abdominal pain (suggesting abdominal aorta claudication) was present in 2 patients, and studies show that almost 50% of LVV patients will present with vascular-related symptoms. 8 Moreover, carotid and abdominal murmurs were discovered in all patients on direct physical examination. All patients had elevated APR, anemia, and thrombocytosis, which showed active state vasculitis.…”

“…All patients had elevated APR, anemia, and thrombocytosis, which showed active state vasculitis. 8 Vasculitides were historically diagnosed via biopsy and histopathology. In recent times, imaging techniques such as PET-CT are gaining importance in diagnosis, 8 although no single investigation gives all diagnostic and prognostic information.…”