Diagnosis and follow up of Takayasu's arteritis by scintigraphy with radiolabelled interleukin 2.

In July 1993 a 17-year-old woman was diagnosed with Takayasu’s arteritis (type I) in the acute stage 1,2 . She had a weak left radial pulse: arterial pressure was 130/70 mm Hg in the right and 100/65 mm Hg in the left arm. Blood tests were in agreement with the diagnosis. The ultrasonographic study and aortography showed a diffuse and circumferential thickening of the intima–media complex resulting in 80% stenosis in the left subclavia distally to the origin of the left vertebral artery (Figure 1A). Therapy with prednisone and acetylsalicylic acid was initiated. She rapidly became free of symptoms and the laboratory tests improved substantially. In February 1994, she complained of recurrent pain, paresthesias of the left arm, and dizziness on neck move- ment. New aortography showed a stenosis of the proximal left subclavia to the origin of the left vertebral artery. Therefore, a new imaging modality was applied to evaluate the activity and extent of the inflammatory process 3 : scinti- graphy with radiolabelled interleukin 2 ( 99m Tc-IL-2). This revealed an abnormal uptake in the area of the left subclavia and at the origin of the left common carotid artery (Figure 2A) indicating the presence of an active process of lympho- cytic infiltration in the arterial wall; methotrexate was added to therapy. In June 1994, all laboratory tests being normal, a percu- taneous transluminal angioplasty was successfully performed (Figure 1B). In June 1998, the therapy was discontinued.