Radiological Imaging In Pediatric Patients with Takayasu Arteritis

Abstract

Takayasu Arteritis (TA) is a rare chronic inflammatory large vessel vasculitis that predominantly affects the aorta and its main branches, leading to significant morbidity and mortality. This condition is most commonly observed in Asian women, though pediatric cases remain exceptionally rare and challenging to diagnose due to varied clinical presentations. We report a case of a 10-year-old girl presenting with bilateral lower extremity weakness, tremors, and constitutional symptoms. Physical examination revealed absent pulsations in bilateral radial arteries, brachialist arteries, and left dorsalis pedis artery. Laboratory findings showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). CT angiography of the thoracic-abdominal region demonstrated diffuse wall thickening of the left common carotid artery, left subclavian artery, and brachiocephalic artery with near-complete occlusion, consistent with Takayasu Arteritis type I. Duplex Sonography Vascular examination of the superior extremities revealed findings suggestive of peripheral arterial disease with suspected Takayasu Arteritis. The patient met the 2022 ACR/EULAR classification criteria with a total score of 5 points, confirming the diagnosis. This case emphasizes the critical role of multimodal imaging approaches, including CT angiography and Duplex Sonography, in the early diagnosis and classification of pediatric Takayasu Arteritis. Prompt radiological evaluation is essential for appropriate management and prevention of severe vascular complications in this rare pediatric population.