Takayasu Arteritis and Pregnancy in a Black Patients in Zambia: A Case Based Review

Takayasu arteritis is a rare large vessel vasculitis.Clinical assessment of the peripheral vascular system is equally essential for diagnosis.Angiography is the imaging modality of choice; a Doppler ultrasound study is an alternative with limited resources.Steroids and anti-hypertensives are the mainstays of treatment.Treatment is individualized, especially in pregnancy, as some immunosuppressants and anti-hypertensives can cause fetal harm.Angioplasty or vascular surgery is reserved for critical organ vascular stenosis.Case: A 29-year-old black African woman presented with severe hypertension in the left arm and unrecordable right arm blood pressure.She had right upper limb claudication.Her peripheral vascular examination was significant for absent pulses at and distal to the right brachial artery.A diagnosis of Takayasu arteritis with possible renovascular involvement was postulated.A Doppler study demonstrated right diminished blood flow at and distal to the right axillary artery, later confirmed by Computed Tomography angiography.Left renal artery stenosis was diagnosed on CT angiography.She was treated with immunosuppressants and antihypertensives with good effect.A month later, she conceived, and medications were changed to pregnancy-friendly alternatives.The pregnancy reached full term, and delivery was uneventful.Conclusion: Takayasu arteritis is rare; angiography is the gold standard investigation tool.Doppler studies are an alternative imaging modality and should be used instead of inappropriate radiography.Treatment can be individualized and adjusted in pregnancy with good outcomes.Surgery or angioplasty does play a role in critical organ vascular stenosis.