Takayasu's arteritis following Crohn's disease in a young woman: any evidence for a common pathogenesis?
Takayasu's arteritis and Crohn's disease are chronic inflammatory diseases of uncertain aetiology. They rarely occur together, with only twenty nine cases of co-existent Takayasu's arteritis and Crohn's disease reported in the literature. In 88% of these cases, Takayasu's arteritis was diagnosed simultaneously or following a diagnosis of Crohn's disease. We present a case of a young Caucasian medical student, incidentally found to have bilateral carotid bruits on auscultation by a colleague. Magnetic resonance angiography revealed stenoses of the common carotid arteries with established collaterals, and a diagnosis of Type 1 Takayasu's arteritis was made. An 18(F)-fluorodeoxyglucose positron emission tomography scan revealed no active disease. Nine months later, she presented with a short history of abdominal pain, vomiting and abdominal distension. Barium follow-through and computer tomography revealed a terminal ileal stricture and proximal small bowel dilation. An extended right hemicoloectomy was performed and histopathology supported a diagnosis of Crohn's disease. This case report is presented with a particular focus on the temporal relationship between these two disease processes and explores whether their concurrence is more than just co-incidence.
Farrant
Melissa- A L
M
Department of Surgery, Bristol Royal Infirmary, The Royal Perth Hospital, GPO Box X2213, Perth 6001, Western Australia. melissafarrant@hotmail.com
Mason
Justin C
JC
Wong
Newton A C S
NA
Longman
Robert J
RJ
D000328:Adult; D001314:Auscultation; D017536:Carotid Artery, Common / Q000473:pathology* / Q000503:physiopathology; D003082:Colectomy; D003097:Collateral Circulation; D003424:Crohn Disease / Q000150:complications* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D033162:Incidental Findings; D018810:Magnetic Resonance Angiography; D013625:Takayasu Arteritis / Q000150:complications* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color