Objective:

This case report highlights the potentially life-threatening complications associated with Takayasu arteritis (TA) and emphasizes the importance of early diagnosis and a multidisciplinary approach to management.

Background:

TA is a rare inflammatory disorder affecting large arteries, often leading to pulseless disease and vascular insufficiency. 

Design/Methods:

We present a unique case of a 17-year-old female with TA, experiencing syncopal episodes and ultimately presenting with a ruptured ovarian cyst, demonstrating the unexpected complications that can arise from this condition. The patient had a history of TA and was being managed with immunologic therapy and warfarin. She initially presented with abdominal pain and an asymmetrical smile, which led to the discovery of the ruptured ovarian cyst. This case involved medical management followed by surgical intervention.

Results:

Despite medical management, the patient's symptomatic hypotension persisted, necessitating surgical intervention. The case illustrates that complications of TA can arise from seemingly unrelated circumstances, as seen in the ovarian rupture with retroperitoneal hemorrhage, which posed a unique risk for watershed infarctions in this patient group.

Conclusions:

This case underscores the need for early diagnosis and prompt therapeutic measures in TA. It also underscores the importance of collaborative efforts between medical and surgical specialties in managing patients with TA, weighing the risks and benefits for their long-term care. Clinicians should consider TA in the differential diagnosis of young patients presenting with systemic symptoms and arterial insufficiency. Further research is required to enhance our understanding of TA's pathogenesis and develop more effective treatment strategies for this challenging disease.