REFRACTORY HYPERTENSION IN A CASE OF TYPE III TAKAYASU ARTERITIS TREATED WITH PERCUTANEOUS AORTOPLASTY- A CASE REPORT

Abstract :

Introduction: Takayasu arteritis is a chronic, medium and large vessel vasculitis of unknown aetiology, affecting aorta and its primary anches and is usually seen in young females. Patients present with non-specific symptoms, syncope, claudication, absent pulses, hypertension or discrepancy in blood pressures. Conventional or MR angiography is used routinely for diagnosis, but biopsy of vessel involved is confirmatory. The mainstay of therapy is glucocorticoids or other immunosuppressive agents. Some patients may need angioplasty or bypass grafting. The disease tends to be progressive with intermittent remissions and exacerbations. Case report: We here with present a 20 yr old hypertensive female with head ache, syncopal attack, feeble peripheral pulses, carotid uits and grade III hypertensive retinopathy, showing involvement of arch and descending aorta and its anches in conventional and MR angiography. Findings were suggestive of TYPE III TAKAYASU ARTERITIS with refractory hypertension, without renal arterial involvement. After initial treatment with steroids followed by aortoplasty, her hypertension improved significantly. An uncommon mechanism of hypertension and prompt response to treatment ings the case for presentation.

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