Abdominal Pain as Presentation of Takayasu's Arteritis in an Adolescent Male Patient

Farhad Zamani, MD; Ramin Shakeri, MD; Omid Modiramani, MD; Reza Malekzadeh, MD

Disclosures

March 16, 2006

Discussion

TA is a rare, nonspecific obliterative arteritis of unknown origin that involves a large or a medium and large vessel with arteritis (Chapel Hill classification); it occurs predominantly in young, Asian females of childbearing age.[2] Reports of the disease in male patients are very rare. The pathologic process involves all layers of the arterial wall. As with many rare diseases, delay in diagnosis is an important issue for patients with TA. TA may present a wide variety of signs and symptoms depending on the vessel that is affected.[8]

It is infrequently associated with chronic abdominal pain and vomiting because mesenteric ischemia is a rare manifestation of the disease. In a recently published article, in a period of 27 years from the 33 patients with descending thoracic or thoracoabdominal aortic aneurysm in association with TA, the revealing symptom of just 7 patients was thoracic or abdominal pain.[9]

This report emphasizes the importance of ensuring a thorough systemic evaluation in individuals who are experiencing abdominal pain with systemic symptoms. TA should be considered as one of the underlying diseases when a patient develops protean manifestations of the gastrointestinal tract, including chronic and recurrent abdominal pain and constitutional symptoms even in male patients.

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