Non-specific aorto-arteriitis involving abdominal aorta branches in an adolescent girl (clinical case)

Methods Patient Dina Zh., female, 14 years old. The patient was admitted to the Department of cardiology and rheumatology of Chelyabinsk regional paediatric hospital on January 15, 2014. Fatigue, dyspnoe, headache, skin rash, BP increase up to 160/100 mm hg were reported. Severe disease was reported upon hospitalization; justification: Polyserositis: bilateral focal pleuropneumonia, class 2 respiratory failure, pancarditis (endomyopericarditis), class 2 heart failure, peritoneal exudation. Treatment resulted in stabilization; heart failure and respiratory failure symptoms were managed. Treatment – arterial hypertension (130/80 – 160/ 110 mm hg) persisted. Pink – to purple livedolike rash appeared on the lower extremities and abdominal wall. Proteinuria (daily loss up to 310 mg) was reported; diuresis level 1350 ml/day. At hospitalization Day 3 hypertension attack was reported; it included BP increase up to 190/ 110 mm/hg, severe headache, spoor progressing to loss of consciousness, and seizures. CT of abdominal cavity with aortography: manifested narrowing of celiac trunk proximal regions, narrowing of superior mesenteric artery isthmus, narrowing of dextral renal artery. Blood circulation was not detected in proximal regions of the sinister renal artery. Inferior mesenteric artery: no significant changes reported. Diagnosis: non-specific aorto-arteriitis (disease of Takajasu), stenosis type 2 involving celiac trunk, superior mesenteric artery, and renal arteries; secondary arterial hypertension, symptomatic epileptic seizures.