Acute Onset of Consciousness Disturbance in a Young Patient Presenting with Asymptomatic Hematuria: A case report

Background Takayasu's arteritis is characterized as a chronic, non-specific inflammatory condition affecting the aorta and its primary branches. In addition to arterial stenosis, some affected vessels exhibit dilatation or aneurysmal changes. The etiology and pathogenesis of Takayasu's arteritis remain unclear, and the disease typically manifests with a relatively slow onset. This type of medication is primarily therapeutic, and the prognosis is generally favorable. In this report, we present a case involving a 21-year-old female patient diagnosed with Takayasu Arteritis (TAK), who exhibited unexplained, residual, painless, intermittent hematuria over a period of two years. This condition culminated in a severe outcome characterized by the sudden onset of pulmonary embolism and cerebral infarction. Case presentation A 21-year-old female patient experienced a sudden episode of syncope and loss of consciousness during a brief journey. Digital subtraction angiography revealed the presence of acute cerebral infarction, pulmonary embolism, and multiple large artery stenoses. The patient had a two-year history of painless hematuria, the etiology of which remained undetermined despite routine diagnostic evaluations. In accordance with the 2022 American College of Rheumatology/EULAR classification criteria, TAK was considered for this patient. Following hospital admission, the patient underwent an urgent embolectomy; however, the prognosis remained unfavorable. Conclusions In cases of young women presenting with painless hematuria where routine examinations do not reveal an underlying cause, it is crucial to consider the potential diagnosis of Takayasu arteritis. Early diagnosis through diagnostic imaging, particularly angiography, is vital, as it can significantly enhance patient outcomes.