Takayasu`s Arteritis Presenting with Dyspnea, Orthopnea , Pleural Effusion and Heart Failure in a Young Patient , Case Report and Literature Review

Background: Takayasu’s arteritis is a rare, idiopathic, chronic granulomatous vasculitis that affects aorta and its major branches.

Case report: This unique case describes an 17- year-old female who presented to our Emergency Room with severe respiratory distress, orthopnea dyspnea and tachypnea, without absent peripheral pulses , Elevated blood pressure In both arms and systolic dysfunction.

Lab results showed elevate inflammatory markers, Computed tomography angiography (CTA) of the chest and abdomen showed bilateral pleural effusion larger on the right side, aneurysmal expansion of the descending thoracic aorta, severe abdominal aortic stenosis and bilateral renal artery stenosis.

MR-angiography of the abdomen demonstrated active arteritis with perivascular wall enhancement of the proximal abdominal aorta and critical narrowing of both the renal arteries and of the origin of the celiac trunk.

A diagnosis of Takayasu`s arteritis was made. Latterly Following treatment with immunosuppressive therapy and beta-blocker, hypertension resolved.

Conclusion: Weight loss, respiratory distress with severe dyspnea and orthopnea may represent the initial symptom of Takayas’s arteritis.

Takayasu arteritis could present without detecting absent peripheral pulses ,the acute presentation of Takayasu arteritis could be mimicker of pulmonary embolism.