A Rare Case of Takayasu’s Arteritis with Hyperthyroidism
835-837
Correspondence
Dr Mohammed Ashraf
Assistant Professor, Department of Medicine
Fr Muller Medical College, Mangalore, India.
Phone: 9448428974; E-mail: drashrafmedd@hotmail.com.
Both Takayasu’s arteritis and hyperthyroidism are of uncertain aetiologies. An autoimmune mechanism has been implicated in both these diseases. We had a patient who presented with both the diseases simultaneously. A 23 year old female patient was admitted with a history of generalised weakness and exertional breathlessness since 15 days. On physical examination, she was found to have pallor and absent pulses in the upper limbs. An early diastolic murmur with S3 was heard on cardiac examination. The diagnosis of aortic regurgitation (AR) with congestive cardiac failure (CCF) due to Takayasu’s arteritis was made. The blood investigations showed elevated ESR and C-reactive protein (CRP). 2DEcho showed global hypokinesia ultrasonography (USG) of the neck showed diffuse goiter. The thought field therapy (TFT) showed that thyroid stimulating hormone (TSH) was 0.01 ug/ml, T4 was 19.18 ug/ml and that TPO was normal but the thyroglobulin antibody levels were elevated (761 U). MDCT showed diffuse stenosis in the bilateral subclavian artery, an aberrant right subclavian artery, the narrowing of the left vertebral, celiac and superior mesenteric arteries and multiple chest wall and intra-abdominal collaterals. She was put on steroids, antithyroid drugs and antiplatelets. One and a half year later, she presented with renovascular hypertension (HTN), and her aortogram showed bilateral renal lesions also. She then underwent angioplasty of the right subclavian and both the renal arteries. She is presently under regular follow up and is doing well.