Cureus. 2026 May 10;18(5):e108590. doi: 10.7759/cureus.108590. eCollection 2026 May.
ABSTRACT
Takayasu arteritis is a chronic large-vessel vasculitis that predominantly affects young women and may lead to severe vascular complications. This case series is noteworthy because it describes Takayasu arteritis revealed by severe cardiovascular and neurovascular complications, including ischemic stroke and advanced heart failure, in young women without traditional cardiovascular risk factors. We report three cases of Takayasu arteritis observed at Ibn Rochd University Hospital in Casablanca in 2024. The median age was 38 years. Two patients presented with ischemic stroke, while one presented with advanced heart failure. Clinical examination revealed upper limb claudication, dyspnea on exertion, decreased or absent radial pulses, carotid bruits, and significant blood pressure asymmetry between upper limbs. Laboratory investigations showed an inflammatory syndrome with elevated C-reactive protein and erythrocyte sedimentation rate, as well as inflammatory anemia. The diagnosis was confirmed by multimodal non-invasive vascular imaging, including Doppler ultrasound, computed tomography (CT) angiography, magnetic resonance (MR) angiography, and positron emission tomography (PET) scan, fulfilling the 2022 American College of Rheumatology classification criteria. All patients received high-dose corticosteroid therapy (1 mg/kg/day) followed by progressive tapering. Standard treatment for heart failure was initiated when indicated, and anticoagulation or antiplatelet therapy was prescribed according to the presence of embolic events. Clinical and biological improvement was observed in all patients, with partial neurological recovery and a significant reduction of inflammatory markers. Takayasu arteritis may present with highly polymorphic clinical presentations, including severe cardiovascular and neurovascular complications as initial manifestations in young women without traditional risk factors. Early recognition through multimodal non-invasive vascular imaging is essential to establish the diagnosis promptly and initiate appropriate treatment, thereby reducing the risk of irreversible complications.
PMID:42125509 | PMC:PMC13160249 | DOI:10.7759/cureus.108590