Abstract
Takayasu vasculitis is a rare type of large vessel vasculitis that primarily affects the aorta and its main branches; signs and symptoms are usually due to systemic inflammation or ischemia of an organ or a limb, depending on the group of blood vessels involved. In addition, Takayasu arteritis is associated with increased platelet and coagulation activity, leading to a hypercoagulable state and thrombus formation. We report a case of a 47-year-old male who presented with a history of complete anuria for 3 days and was found to have progressively worsening kidney function. Renal Doppler ultrasound confirmed the presence of bilateral renal artery thrombosis, while contrast-enhanced computed tomography (CECT) of the abdomen and pelvis showed extensive abdominal aortic thrombosis with radiological findings consistent with large vessel vacuities. After catheter-directed thrombolytic therapy of the renal arteries, the patient started producing urine and his kidney function significantly improved. Later, positron emission tomography scan (PET) confirmed large vessel Takayasu arteritis. Echocardiography showed no intracardiac thrombus, along with an extensive work-up for thrombophilia, as autoimmune and vasculitis serology came back negative. This is an extremely rare presentation of Takayasu arteritis, with an unusual recovery of acute renal failure after prolonged anuria due to bilateral renal artery thrombosis.
Highlights
Takayasu vasculitis is a rare type of large vessel vasculitis that primarily affects the aorta and its main branches; signs and symptoms are usually due to systemic inflammation or ischemia of an organ or a limb, depending on the group of blood vessels involved
We report a case of a 47-year-old male who presented with a history of complete anuria for 3 days and was found to have progressively worsening kidney function
This case report signifies the importance of early identification of symptoms and signs of rare diseases such as Takayasu Arteritis which in turn leads to early diagnosis and treatment
Summary
Secondary to aortic thrombosis is infrequent, often associated with atherosclerotic and/or aneurysmal changes, rarely caused. Takayasu large vessel vasculitis (nonspecific) is one of the rare causes of aortic thrombosis [1], and is often missed, it is a reversible and treatable condition. Takayasu vasculitis is a rare type of granulomatous vessel vasculitis, and it is considered a chronic inflammatory condition that primarily affects the aorta and its main branches; the exact cause is not well established. Takayasu arteritis (TA) is associated with increased platelet and coagulation activity, leading to a hypercoagulable state and thrombus formation [2]. This case report describes a rare case of TA presenting with anuric renal failure. Written informed patient consent was obtained in the present study
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