Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 7, 2008; 14(25): 4087-4090
Published online Jul 7, 2008. doi: 10.3748/wjg.14.4087
Takayasu’s arteritis following Crohn’s disease in a young woman: Any evidence for a common pathogenesis?
Melissa AL Farrant, Justin C Mason, Newton ACS Wong, Robert J Longman
Melissa AL Farrant, Department of Surgery, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, United Kingdom
Justin C Mason, Rheumatology Unit, Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom
Newton ACS Wong, Department of Histopathology, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, United Kingdom
Robert J Longman, Colorectal Unit, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, United Kingdom
Author contributions: Farrant MAL wrote the case report with a significant contribution from Longman RJ and Mason JC. Wong NACS provided the pathology section and the contributing figure.
Correspondence to: Dr. Melissa AL Farrant, Department of Surgery, Bristol Royal Infirmary, The Royal Perth Hospital, GPO Box X2213, Perth 6001, Western Australia. melissafarrant@hotmail.com
Telephone: +61-8-92242244
Fax: +61-8-92241939
Received: March 12, 2008
Revised: April 16, 2008
Accepted: April 23, 2008
Published online: July 7, 2008
Abstract

Takayasu’s arteritis and Crohn’s disease are chronic inflammatory diseases of uncertain aetiology. They rarely occur together, with only twenty nine cases of co-existent Takayasu’s arteritis and Crohn’s disease reported in the literature. In 88% of these cases, Takayasu’s arteritis was diagnosed simultaneously or following a diagnosis of Crohn’s disease. We present a case of a young Caucasian medical student, incidentally found to have bilateral carotid bruits on auscultation by a colleague. Magnetic resonance angiography revealed stenoses of the common carotid arteries with established collaterals, and a diagnosis of Type 1 Takayasu’s arteritis was made. An 18F-fluorodeoxyglucose positron emission tomography scan revealed no active disease. Nine months later, she presented with a short history of abdominal pain, vomiting and abdominal distension. Barium follow-through and computer tomography revealed a terminal ileal stricture and proximal small bowel dilation. An extended right hemicolectomy was performed and histopathology supported a diagnosis of Crohn’s disease. This case report is presented with a particular focus on the temporal relationship between these two disease processes and explores whether their concurrence is more than just co-incidence.

Keywords: Crohn’s disease; Granuloma; Takayasu’s arteritis