The heart of the matter: An atypical presentation of Takayasu arteritis in the pediatric emergency department

Daniel M. Fein, Ginger Janow, Jeffrey R. Avner, Michele J. Fagan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Takayasu arteritis (TA) is a rare chronic large-vessel vasculitis of unknown etiology. Although commonly thought of as an adult disease, initial manifestations frequently appear during adolescence. This is a case discussion of an 11-year-old boy with a recent history of fever who presented with shortness of breath, sore throat, chest pain, hypertension, and a new murmur. He had a markedly elevated antistreptolysin O titer, had a prolonged PR interval, and was initially evaluated with acute rheumatic fever. After admission, he had persistent hypertension, proteinuria, and hemoptysis, which prompted a magnetic resonance angiography that revealed aortic enhancement and thickening, and he was evaluated with TA. To our knowledge, this is the first case report in the pediatric literature of TA presenting with heart block. This case highlights the recondite nature of the systemic vasculitides and emphasizes the importance of keeping a broad differential diagnosis when seeing patients who present with common complaints.

Original languageEnglish (US)
Pages (from-to)857-859
Number of pages3
JournalPediatric Emergency Care
Volume27
Issue number9
DOIs
StatePublished - Sep 2011

Fingerprint

Takayasu Arteritis
Hospital Emergency Service
Pediatrics
Antistreptolysin
Hypertension
Systemic Vasculitis
Heart Block
Rheumatic Fever
Hemoptysis
Pharyngitis
Magnetic Resonance Angiography
Vasculitis
Chest Pain
Proteinuria
Dyspnea
Differential Diagnosis
Fever

Keywords

  • acute rheumatic fever
  • heart block
  • Takayasu arteritis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

The heart of the matter : An atypical presentation of Takayasu arteritis in the pediatric emergency department. / Fein, Daniel M.; Janow, Ginger; Avner, Jeffrey R.; Fagan, Michele J.

In: Pediatric Emergency Care, Vol. 27, No. 9, 09.2011, p. 857-859.

Research output: Contribution to journalArticle

Fein, Daniel M. ; Janow, Ginger ; Avner, Jeffrey R. ; Fagan, Michele J. / The heart of the matter : An atypical presentation of Takayasu arteritis in the pediatric emergency department. In: Pediatric Emergency Care. 2011 ; Vol. 27, No. 9. pp. 857-859.
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