Takayasu Arteritis Presenting with Resistant Hypertension and Aortic Stenosis: A Case Report

Abstract

Background: Takayasu arteritis (TA) is a rare large-vessel vasculitis primarily affecting young women. It is characterized by granulomatous inflammation of the aorta and its main branches, leading to stenosis, occlusion, or aneurysm formation. Clinical manifestations are heterogeneous and often delay diagnosis.

Case presentation: We report a 41-year-old female with longstanding arterial hypertension who presented with resistant hypertensive crises, thoracic pain, claudication, and paresthesias. Her medical history included a diagnosis of TA during adolescence, but without consistent follow-up or immunosuppressive treatment. Current imaging revealed significant aortic and iliac artery stenosis. Laboratory and clinical criteria fulfilled the 2022 ACR/EULAR classification for TA. She responded well to intravenous methylprednisolone pulses, followed by methotrexate and oral prednisone maintenance.