Takayasu Arteritis Presenting with Gangrene: A Case Report

Abstract

Takayasu Arteritis (TA) is a chronic inflammatory disease affecting large blood vessels, particularly the aorta and its branches, making it a type of vasculitis. It is reported to be highly prevalent in Southeast Asian countries. Clinical presentations may vary, including headache, weight loss, malaise, fever, hypertension, visual disturbances, and musculoskeletal symptoms. Gangrene is a rare manifestation of TA, with relatively few cases reported globally. If gangrene is present, it is commonly noted in the lower limbs. Inflammation of the blood vessels caused by TA might lead to stenosis of the affected vessels. The underlying pathophysiology of gangrene development in TA is poorly understood but is mainly attributed to the occlusion of blood vessels. It is associated with inflammatory markers produced by lymphocytes and macrophages. Immunosuppressive drugs are recommended for symptomatic relief. Early diagnosis and intervention can be useful in managing TA, preventing adverse outcomes, and reducing its financial, social, and psychological consequences. This is a case report of a 32-year-old female, presented with gangrene and a history of rheumatoid arthritis. Further examination revealed a presentation of TA. The patient was managed by below-knee amputation for gangrene of the left leg and medical management for TA. Therefore, authors aim to draw attention to the diagnosis of TA and the rare associated morbidity, ‘gangrene,’ and the importance of timely intervention.

Keywords

• below knee amputation
• critical limb ischaemia
• limb claudication
• pulselessness
• vasculitis