Takayasu's arteritis. Protean manifestations.

An adolescent girl presented with fever, weight loss, and headache. Despite extensive diagnostic studies, the diagnosis of Takayasu's arteritis was made only after she developed bruits and diminished pulses. Although the initial manifestations of Takayasu's arteritis are often protean and confusing, characteristic clinical and radiographic findings develop after the onset of vascular insufficiency. The chest radiograph may provide an early clue to diagnosis, which can be confirmed by arterial digital subtraction aortography. Physicians should consider Takayasu's arteritis in the differential diagnosis of prolonged fever or weight loss in young females because treatment appears to be more effective when started early.