Combined Takayasu Arteritis and Hashimoto Thyroiditis During 3 Consecutive Pregnancies: Figure 1.

Abstract

To the Editor: A 25-year-old Turkish primigravida presented with Bell’s palsy, numbness of the right side of the face, and pain of the right anterior neck in her 30th week of pregnancy. Thyroxine was given for previously known Hashimoto’s thyroiditis. Blood pressure was 110/70 mm Hg at her left arm and 90/65 mm Hg at her right arm. Pulses were absent at her right arm; there were bruits over both carotid arteries. Erythrocyte sedimentation rate (ESR) was 68 mm/h, C-reactive protein (CRP) 1.4 mg/dl. Thyroid-stimulating hormone (TSH) was mildly elevated, antithyroid peroxidase (anti-TPO) antibodies and anti-thyroglobulin (anti-Tg) antibodies were highly positive. Ultrasound showed long edematous concentric wall thickening of both common carotid arteries with a 50% stenosis, as well as an occlusion of the right subclavian artery confirmed by magnetic resonance (MR) angiography (Figure 1). There were no signs of cerebral or retinal abnormalities or involvement of the abdominal aorta or renal arteries. Prednisolone 1 mg/kg/day was started for Takayasu arteritis (TA) and tapered to 20 mg/day with additional low-dose aspirin … Address reprint requests to Dr. F. Förger, Department of Rheumatology, Clinical Immunology and Allergology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland. E-mail: Frauke.Foerger{at}insel.ch