Ishaq and Shabbir Journal of Medical Case Reports 2011, 5:466 http://www.jmedicalcasereports.com/content/5/1/466 C A S E R E P O R T JOURNAL OF MEDICAL CASE REPORTS Open Access Takayasu’s arteritis presenting with temporary loss of vision in a 23-year-old woman with beta thalassemia trait: a case report Mohammad G Ishaq and Fahad A Shabbir* Abstract Introduction: The simultaneous presence of Takayasu’s arteritis and beta thalassemia trait is a rare combination. To the best of our knowledge, this is the first case report on Takayasu’s arteritis and beta thalassemia presenting together. Case presentation: This is a case report of a 23-year-old Asian woman of Pakistani descent who presented with a headache, blurred vision and dizziness. Conclusion: The correct diagnosis of our patient was based on clinical suspicion, appropriate imaging studies, and deliberation of the differential diagnosis. The management of our patient depended on the correct diagnosis of both the diseases. Introduction Takayasu’s arteritis (TA) is an autoimmune, chronic, progressive, large-vessel vasculitis that usually affects young adults, especially women. The disease can affect all races and ethnic groups. The diffuse nature of this vasculitis can involve multiple organ systems to varying degrees and can present with a wide range of symptoms [1], with an incidence of one to two cases per million people per year [2]. Beta thalassemia trait is an autoso- mal recessive disorder characterized by a point mutation on the beta-globin chain gene on chromosome 11, resulting in the defective synthesis of the beta-globin chain of hemoglobin [3]. To the best of our knowledge, the incidence of TA with beta thalassemia trait has not previously been reported in the literature. Case Presentation A 23-year-old Asian woman of Pakistani descent pre- sented with blackouts, blurring of vision and headache for more than two months duration. The headaches started in the frontal region then radiated to the whole head, were moderate in intensity and were associated with vertigo, dizziness, palpitations and postural weakness. Her past * Correspondence: fahad.shabbir@mail.com Department of Medicine, Jinnah Medical College Hospital, SR-6 Sector 7/A KIA, Korangi, Karachi, Pakistan medical history revealed that she had been diagnosed with epilepsy two months previously, after which she had been given antiepileptic medication. She had been using the medication regularly since being diagnosed. On general examination, pulses in both her upper limbs were deficient and so her blood pressure could not be measured. Our patient was also found to be anemic. On cardiovascular examination a bruit was heard over her left subclavian fossa. Fundoscopy revealed optic disk cupping with irregu- lar margins in her right eye; her left eye was unaffected. All other examination, including respiratory and central nervous system examinations, were unremarkable. A psy- chiatric evaluation was also inconclusive. Our patient had anemia (hemoglobin 10 g/dL), throm- bocytosis (494,000/mL) and raised erythrocyte sedimen- tation rate (ESR) (35 mm/hr). The morphology of the red blood cells showed microcytosis and hypochromasia. An investigation into the serum ferritin revealed that it was well above the normal range (315.5 ng/mL). Hemo- globin electrophoresis presented with a mean corpuscu- lar volume of 58.7 fL, mean corpuscular hemoglobin of 19.2 pg, and hemoglobin A2 of 4.7%. Liver enzymes were significantly raised (direct bilirubin 0.3 mg/dL, ala- nine transaminase 152 U/L, alkaline phosphatase 317 U/ L). The C-reactive protein test was also reactive. In addition the following investigations were unremarkable: © 2011 Ishaq and Shabbir; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.