Takayasu’s arteritis following Crohn’s disease in a young woman: Any evidence for a common pathogenesis?

Figure 1 Ultrasound image of the right common carotid artery showing wall thickening (arrows) and blood flow with a significantly enhanced peak systolic velocity (PS > 587 cm/s), indicating a severe stenosis (A) and magnetic resonance angiography showing occlusion of the left common carotid (white arrows) and stenosis of the right common carotid (black arrows) arteries (B).

Figure 2 Barium follow through showing a stricture at the terminal ileum (white arrows) typical of Crohn’s disease with dilated ileum just proximal to it (black arrows) (A) and axial CT image showing the thickened terminal ileum (arrow) and associated inflammatory change (B).

Figure 3 A: Whole histological mount of the terminal ileal stricture showing part of its stenosed lumen (L), with the caecum (C) and ileum (I) at either end. The stricture showed transmural chronic inflammation (examples of the numerous lymphoid follicles are arrowed) with extensive fibrosis (F); B: Well-formed granulomas (G) with surrounding chronic inflammation in the subserosal tissues around the stricture with no vasculitis in an arrowed small muscular artery; C: Ileal mucosa proximal to the stricture showing extensive ulcer-associated cell lineage (arrowed) and chronic inflammation extending into the hypertrophied muscularis mucosae (MM); D: A medium-sized muscular artery within the fibrous tissue of the stricture showing chronic inflammation and multinucleated giant cells (arrowed) concentrated around the outer edge of the media (M) and the lumen of the artery in the bottom right corner.