Takayasu Arteritis Presenting as Recurrent Diabetic Ketoacidosis Attacks in a Patient with Type 1 Diabetes Mellitus

Takayasu arteritis (TA) is a rare, idiopathic, granulomatous large vessel arteritis that primarily affects the aorta and its branches. Diabetic ketoacidosis (DKA) represents the most common hyperglycemic emergency in individuals with diabetes mellitus. Triggering factors for DKA can include infections, trauma, acute pancreatitis, certain medications, and ischemic vascular events. Hereby a female patient in her 30s with type 1 diabetes, who presented with vague abdominal pain, nausea, and fatigue, is presented. Initial evaluation indicated findings consistent with DKA, including hyperglycemia, acidosis, and ketonuria. No underlying conditions, such as infection, were identified. Although the DKA episode subsided, the severity of her abdominal pain intensified, and acute phase reactants were elevated. Abdominal computed tomography revealed thickening of the abdominal aortic wall, and aortic magnetic resonance angiography confirmed findings consistent with TA. Immunosuppressive treatment was initiated. During the 1-year follow-up, the patient experienced only 1 additional episode of DKA following the diagnosis of TA. To our knowledge this is the first reported case of Takayasu arteritis one manifesting as recurrent DKA attacks in the literature.

Cite this article as: Döngelli H, Kocabaş ME. Takayasu arteritis presenting as recurrent diabetic ketoacidosis attacks in patient with type 1 diabetes mellitus. Endocrinol Res Pract. Published online May 16, 2025. doi 10.5152/erp.2025.24608.