Bierge-Mascorro J, Márquez-Toledo A

Language: Spanish
References: 11
Page: 204-206
PDF size: 237.65 Kb.

ABSTRACT

A case of a female aged 16 is presented; she was initially admitted for study protocol in the service of pediatrics at the University Hospital of Puebla with the diagnosis of unexplained fever. She had had a fever for over a month, previously multitreated. Her physical examination was normal, except for a 39^oC fever, headache and limb claudication. Laboratory and imaging studies were performed as investigation of fever of unknown origin: normochromic normocytic anemia, monocytosis, thrombocytosis and prolonged clotting times were found, the ESR and CRP were increased, in addition to EBV positive serology; the remaining studies were normal. Acyclovir was administered and she obtained partial improvement. Subsequently, an epigastric murmur and differences in the blood pressure in both arms were added. Echo-Doppler of the abdominal aorta was performed, and it reported aortitis with decreased flow velocity. A CT angiography showed aortitis of abdomen and chest, with arteritis of the common carotid and brachiocephalic trunk. With these findings, Takayasu arteritis in early stage was diagnosed, according to the Ishikawa criteria modified by Sharma BK et al, and the criteria of the American College of Rheumatology. Treatment was initiated with steroids and she presented with clinical improvement.

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