Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan.
The number of Takayasu arteritis (TAK) cases being diagnosed at an advanced age has increased, including some who develop ischemic lesions without inflammation of the involved arteries long after the onset of TAK. However, few histopathological analyses of such patients without immunosuppressive therapy have been reported. We herein report a 92-year-old woman with atypical aortic coarctation complicating TAK who underwent bypass graft surgery and survived for 23 years without immunosuppressive therapy. Microscopic findings at the autopsy revealed clear differences between the affected and unaffected arteries. This case suggests that inflammation severe enough to destroy the structure of the aorta may not inherently be sufficient to promote systemic atherosclerosis.
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