Febbre persistente, dolore toracico e artrite di Takayasu

Takayasu’s arteritis (TA) is an extremely rare vasculitis that presents in paediatric age that typically affects adolescents. Clinical manifestations of TA are polymorph and in the fists stage of the disease systemic aspecific symptoms such as fever, asthenia, chest pain, sweating and athromyalgias prevail. Only in late stages do specific signs due to the occlusion of the vessels appear. Therefore, early diagnosis is a real diagnostic challenge. It is necessary to keep a high suspicion index in adolescents especially in females that present with aspecific symptoms such as fever, uneasiness, anaemia, loss of weigh, and chest pain associated with an increase in the inflammation indexes without signs of localisation. In the early stages of the disease, when the clinical diagnosis may be often difficult, total-body PET may be of help. The paper describes the case of a 14-year old girl who presented with persistent fever, chest pain associated with a remarkable increase in the inflammation indexes. After a long diagnostic process, the focus on the patient’s chest pain made it possible to suspect first and then to diagnose Takayasu’s arteritis.