Sudden death due to Takayasu arteritis complication associated with situs inversus totalis: A case discovered at autopsy |
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| Institution: | 1. Department of Forensic Medicine, University Hospital of Fattouma Bourguiba of Monastir, 5000, Tunisia;2. Department of Pathology, University Hospital of Fattouma Bourguiba of Monastir, 5000, Tunisia;1. University of Miami Miller School of Medicine, Miami, FL, USA;2. Division of General Surgery, Department of Surgery, Stanford University, Stanford, CA, USA;3. New York Eye and Ear Infirmary at Mount Sinai, New York, NY, USA;4. Department of Obstetrics & Gynecology, Boston University, Boston, MA, USA;5. Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, USA;1. Section of Legal Medicine, Department of Social Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan;2. Department of Radiology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan;1. Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman;2. Internal Medicine Training Program, Oman Medical Specialty Board, Muscat, Oman;3. College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman;1. National Group of Clinical, Psychology and Forensic Psychiatry, National Institute of Legal Medicine and Forensic Sciences, Bogotá, Colombia;2. Bogotá Regional Office (DRB in Spanish), National Institute of Legal Medicine and Forensic Sciences, Bogotá, Colombia;3. Bogotá Regional Office (DRB in Spanish), National Institute of Legal Medicine and Forensic Sciences, National University of Colombia, Bogotá, Colombia;4. Hospital Universitario Mayor – Méderi, Universidad del Rosario, Bogotá, Colombia;5. Universidad del Rosario, Bogotá, Colombia;6. Universidad de Pernambuco, Bogotá, Colombia |
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| Abstract: | Takayasu arteritis is a rare pathology that usually has general and atypical signs that make its diagnosis difficult. These characteristics can delay diagnosis, thus leading to complications and death. We, herein, report an autopsy case of a 25-year-old female patient with a history of multiple consultations for dyspnea. During these consultations, no diagnosis was made. She was found unconscious near her home and shortly after, she was declared dead. Forensic autopsy revealed superficial traumatic lesions. Internal examination revealed complete situs inversus. Multiple bilateral pleural adhesions and bilateral moderate effusion were found. The heart was heavy with thickening of the aortic wall (1.1cm), carotid arteries, and pulmonary trunk, associated with a large aortic valve and evidence of leakage. Histological examination of the aorta and its major branches showed features of panarteritis with segmental involvement. The vascular wall was thick with lymphoplasmacytic infiltrate and giant cells involving mainly the medio-adventitial junction. Disruption of the elastic lamina and reactive fibrosis in the intima were also noted. Diagnosis of large vessel vasculitis and particularly Takayasu arteritis was made.Death was therefore attributed to heart failure due to aortic insufficiency as a complication of Takayasu arteritis. |
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| Keywords: | Takayasu arteritis Situs inversus Insufficiency Aortic valve Autopsy Sudden death TAK"} {"#name":"keyword" "$":{"id":"pc_1uW0SJ0hmp"} "$$":[{"#name":"text" "_":"Takayasu arteritis |
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