{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T05:10:23Z","timestamp":1766553023147,"version":"3.48.0"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med&amp;#65533;Insights&amp;#65533;Arthritis&amp;#65533;Musculoskelet Disord"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Takayasu arteritis (TA) is a rare, chronic inflammatory disease that primarily affects large arteries, and in childhood (c-TA), it often presents with diverse and delayed manifestations that complicate diagnosis. We describe 2 pediatric cases that highlight the importance of early recognition and intervention. The first was a 3-month-old girl who presented with fever, respiratory distress, and peripheral cyanosis. Laboratory investigations revealed leukocytosis, anemia, elevated inflammatory markers, and hypercoagulability, while Doppler ultrasound and computed tomography angiography (CTA) demonstrated extensive vascular involvement with arterial occlusions and aneurysms. She was diagnosed with c-TA based on the American College of Rheumatology (ACR)\/European League Against Rheumatism (EULAR) criteria and responded favorably to high-dose corticosteroids, infliximab, methotrexate, and antiplatelet therapy. The second case was a 17-year-old female with a history of hypertensive encephalopathy who presented with chest pain, arm numbness, and exertional dyspnea. Examination showed absent pulses and significant blood pressure discrepancies in the upper limbs, while laboratory tests revealed elevated erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and positive antinuclear antibody (ANA). The CTA confirmed severe stenosis and occlusions in multiple arteries, fulfilling the diagnostic criteria for TA. Despite treatment with sarilumab, corticosteroids, methotrexate, and antiplatelet therapy, she continued to experience symptoms and required further intervention. These cases underscore the need to consider TA in pediatric patients with hypertension, absent or diminished pulses, blood pressure discrepancies, limb claudication, chest pain, or unexplained systemic inflammatory symptoms. Early recognition and aggressive immunosuppressive therapy are essential to prevent irreversible vascular damage and improve long-term outcomes.<\/jats:p>","DOI":"10.1177\/11795441251406902","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T05:05:56Z","timestamp":1766552756000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diverse Vascular Manifestations of Takayasu Arteritis: Coronary Artery Stenosis and Aneurysmal Dilation in pediatric patients"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9448-1428","authenticated-orcid":false,"given":"Amira","family":"Hussein","sequence":"first","affiliation":[{"name":"Pediatric Cardiology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Hafez","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sohier","family":"Yahia","sequence":"additional","affiliation":[{"name":"Pediatric Genetics Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa","family":"Abdelrahman","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona M","family":"Sabaa","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease and Malnutrition Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doaa Mosad","family":"Mosa","sequence":"additional","affiliation":[{"name":"Department of Rheumatology &amp; Rehabilitation, Mansoura University Hospitals, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayada","family":"Zeid","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease and Malnutrition Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","unstructured":"Tullus K Marks SD. Vasculitis in children and adolescents: clinical presentation etiopathogenesis and treatment. Paediatr Drugs. 2009;11:375-380. Accessed December 8 2025. https:\/\/link.springer.com\/10.2165\/11316120-000000000-00000","DOI":"10.2165\/11316120-000000000-00000"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/1546-0096-12-21"},{"key":"e_1_3_3_4_2","doi-asserted-by":"crossref","unstructured":"Rutter M Bowley J Lanyon PC Grainge MJ Pearce FA. A systematic review and meta-analysis of the incidence rate of Takayasu arteritis. Rheumatology. 2021;60:4982-4990. Accessed December 8 2025. https:\/\/academic.oup.com\/rheumatology\/article\/60\/11\/4982\/6263849","DOI":"10.1093\/rheumatology\/keab406"},{"key":"e_1_3_3_5_2","doi-asserted-by":"crossref","unstructured":"Mathew AJ Goel R Kumar S Danda D. Childhood-onset Takayasu arteritis: an update. Int J Rheum Dis. 2016;19:116-126. Accessed December 8 2025. https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1756-185X.12718.","DOI":"10.1111\/1756-185X.12718"},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","unstructured":"Onen F Akkoc N. Epidemiology of Takayasu arteritis. La Presse M\u00e9dicale. 2017;46: 203. Accessed December 8 2025. https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0755498217303184","DOI":"10.1016\/j.lpm.2017.05.034"},{"key":"e_1_3_3_7_2","doi-asserted-by":"crossref","unstructured":"Aeschlimann FA Yeung RSM Laxer RM. An update on childhood-onset Takayasu arteritis. Front Pediatr. 2022;10:872313. Accessed December 8 2025. https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2022.872313\/full","DOI":"10.3389\/fped.2022.872313"},{"key":"e_1_3_3_8_2","doi-asserted-by":"crossref","unstructured":"Jales-Neto LH Levy-Neto M Bonfa E de Carvalho JF Pereira RM. Juvenile-onset Takayasu arteritis: peculiar vascular involvement and more refractory disease. Scand J Rheumatol. 2010;39:506-510. Accessed December 8 2025. http:\/\/www.tandfonline.com\/doi\/full\/10.3109\/03009741003742730","DOI":"10.3109\/03009741003742730"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq167"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/bf01744547"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-120-11-199406010-00004"},{"key":"e_1_3_3_12_2","doi-asserted-by":"crossref","unstructured":"Tezuka D Haraguchi G Ishihara T et al. Role of FDG PET-CT in Takayasu arteritis: sensitive detection of recurrences. JACC Cardiovasc Imaging. 2012;5:422-429. Accessed December 8 2025. https:\/\/www.sciencedirect.com\/science\/article\/pii\/S1936878X12001660","DOI":"10.1016\/j.jcmg.2012.01.013"},{"key":"e_1_3_3_13_2","doi-asserted-by":"crossref","unstructured":"Xu Y Luo L Su G et al. Clinical characteristics and risk factors of coronary artery lesions in Chinese pediatric Takayasu arteritis patients: a retrospective study. 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