A Case of Takayasu Arteritis with Thrombotic Microangiopathy Secondary to Malignant Hypertension Due to Bilateral Renal Artery Stenosis

An Unusual Case of Severe Hypertension Presenting With Leg Weakness, Hypokalemia, and Hyperreninemic Aldosteronism

Takayasu's arteritis is a rare vasculitis characterized by granulomatous inflammation of the large vessels, typically occurring in the second or third decade of life and preferentially affecting females. It commonly involves large vessels such as the aorta and its major branches (carotid and iliac arteries). Visceral arterial involvement is uncommon and reported in only a minority of patients. Clinical manifestations of Takayasu arteritis are heterogeneous and could include nonspecific symptoms such as fever of unknown origin, asthenia, myalgias, intermittent claudication, angina, and mild arterial hypertension. The rarity of this disease and the extreme heterogeneity of clinical manifestations often lead to delays in diagnosis, lasting more than three years in some patients. Improving knowledge of its diagnostic workup could help clinicians in prompt clinical suspicion and early diagnosis. Here, we aim to describe a particular case of a 40-year-old woman with severe hypertension symptomatic for dizziness, gait instability, leg weakness, and diffuse cramps caused by renovascular hypertension as the first clinical manifestation of Takayasu's arteritis involving the right renal artery.