Clinical Images: Takayasu arteritis diagnosed by positron emission tomography

✍ Scribed by Kunihiro Yamaoka; Kazuyoshi Saito; Shingo Nakayamada; Makiko Yamamoto; Yoshiya Tanaka

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 85 KB
• Volume: 56
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.22723

✦ Synopsis

The patient, a 67-year-old woman with no obvious symptoms, presented at our clinic when she experienced a minor injury. Blood tests revealed anemia, an elevated erythrocyte sedimentation rate, and a slightly increased C-reactive protein level. Positron emission tomography (PET) showed positive uptake at the aortic arch, thoracoabdominal aorta, and brachiocephalic artery (A and B). Angiographic imaging revealed irregularity of the arterial wall at the location identified by PET, and lung perfusion scintigraphy showed defects at the left middle and lower lung fields. Since there were no symptoms suggesting giant cell (temporal) arteritis and no complications or serologic findings indicating arteriosclerosis, Takayasu arteritis was diagnosed. Treatment with high-dose steroids led to pronounced improvement of the lung perfusion and arterial wall thickening within 2 months. To our knowledge, this is the first report of asymptomatic Takayasu arteritis diagnosed by PET, showing the efficacy of this technique in detecting arteritis.