PS 14-24 INITIAL MANIFESTATION OF TAKAYASU'S ARTERITIS AS POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME

Objective: Takayasu's arteritis (TA), also known as “aortic arch syndrome” and “nonspecific aortoarteritis”, is an idiopathic inflammatory disease of large vessel granulomatous vasculitis with massive intimal fibrosis and vascular narrowing. Design and Method: It often affects young or middle-aged women of Asian descent and the aorta as well as its branches. TA can present as pulseless upper extremities which may be why it is also commonly referred to as the “pulseless disease”. Involvement of renal arteries may lead to presentation as renovascular hypertension. Results: Posterior reversible encephalopathy syndrome (PRES) is a neuroradiologic condition that has been mostly associated with severe hypertension, endothelial injury, and conditions such as renal disease, immunosuppressive medication use, and rheumatologic diseases. Headaches, seizures, and altered mental status are the main clinical features as well as characteristic findings in magnetic resonance imaging (MRI). We report a 16-year-old female who presented with recurrent headache, blurred vision, nausea and vomiting for six months. Her blood pressure was 190/100 mmHg and MRI showed typical hyperintense signals on T2 and FLAIR images involving bilateral cingulated gyrus, occipital lobe, and frontal lobe vertex. Percutaneous transluminal balloon angioplasty of the stenotic left renal artery was performed. Conclusions: Although TA is an autoimmune vasculitis rarely associated with PRES that was identified in several connective tissue diseases, it should be included in the differential diagnosis of severe headache attacks, blurred vision, and altered mentality in TA.