title: Takayasu's arteritis and primary antiphospholipid syndrome presenting as hypertensive urgency.
abstract: A 33-year-old Caucasian man was admitted to the hospital with chest pain and hypertensive urgency. Physical examination revealed widespread arterial bruits and marked difference in blood pressure between the upper limbs. Vascular imaging showed widespread narrowing in multiple vascular territories. He met the established American College of Rheumatology criteria for Takayasu's arteritis. His resistant hypertension was considered to be a consequence of bilateral renal artery stenosis and he subsequently underwent sequential stenting of his renal arteries leading to improvement in blood pressure and reduction in the number of antihypertensive medications. Subsequent imaging revealed progression of aortic thrombus in the setting of an elevated erythrocyte sedimentation rate, and persistently elevated antiphospholipid antibodies fulfilling diagnostic criteria for primary antiphospholipid syndrome, requiring initiation of immunosuppression and anticoagulation.
authors.affiliation: University of Saskatchewan, Regina, Saskatchewan, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Yang
authors.affiliation: Department of Radiology, Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Nayeemuddin
authors.affiliation: Department of Nephrology, Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
authors.forename: Bhanu
authors.initials: B
authors.lastname: Prasad
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000175:diagnosis*; D001012:Aorta, Abdominal / Q000002:abnormalities; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D012078:Renal Artery Obstruction / Q000175:diagnosis / Q000601:surgery; D015607:Stents; D013625:Takayasu Arteritis / Q000150:complications / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed
chemical_list: D007166:Immunosuppressive Agents