Bronchiectasis and hoarseness of voice in takayasu arteritis: a rare presentation

BMC Research Notes

Aruna Kulatunga¹  Lalindra D Dias¹  Anusha C Jayasinghe¹  Gamage ND Perera¹ 

[1] National Hospital of Sri Lanka, Colombo, Sri Lanka

关键词: Pericardial effusion;    Recurrent laryngeal nerve palsy;    Bronchiectasis;    Takayasu arteritis;   

Others  :  1165920
DOI  :  10.1186/1756-0500-5-447

 received in 2012-05-29, accepted in 2012-08-18,  发布年份 2012

【 摘 要 】

Background

Takayasu arteritis is a large vessel vasculitis occurring in young females. We report a rare presentation of Takayasu arteritis in a Sri Lankan woman. She presented with bronchiectasis and left recurrent laryngeal nerve palsy prior to the onset of vascular symptoms. This case illustrates an atypical presentation of this disease and the diagnostic dilemma that the physician may be faced with.

Case presentation

A 39-year-old woman presented with chronic cough, haemoptysis and hoarseness of voice. She had left recurrent laryngeal nerve palsy and high inflammatory markers on investigation. CT thorax revealed aortic wall thickening and traction bronchiectasis. 2 D echocardiogram revealed grade 1 aortic regurgitation compatible with aortitis. She did not have weak peripheral pulses or a blood pressure discrepancy and did not meet American College of Rheumatology (ACR) criteria for diagnosis of Takayasu arteritis at this stage. Tuberculosis, syphilis and sarcoidosis was excluded. While awaiting angiography, she developed left arm claudication and a pericardial effusion. Angiography revealed evidence of Takayasu arteritis and absence of flow in the left subclavian artery. Takayasu arteritis was diagnosed at this stage after a period of eight months from the onset of initial symptoms. She is currently on prednisolone, azathioprine and aspirin.

Conclusion

Bronchiectasis and recurrent laryngeal nerve palsy is a rare presentation of Takayasu arteritis. Atypical presentations can occur in Takayasu arteritis prior to the onset of vascular symptoms. Elevation of inflammatory markers are an early finding. A high degree of suspicion is needed to identify these patients in the early course of the disease.

【 授权许可】

   
2012 Perera et al.; licensee BioMed Central Ltd.

【 图 表 】

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