Acute Onset of Consciousness Disturbance in a Young Patient Presenting with Asymptomatic Hematuria: A case report

Acute Onset of Consciousness Disturbance in a Young Patient Presenting with Asymptomatic Hematuria: A case report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Acute Onset of Consciousness Disturbance in a Young Patient Presenting with Asymptomatic Hematuria: A case report Zhou Juan, Ao Haijiao, Zhang Lu, Liu Yang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6598093/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Takayasu's arteritis is characterized as a chronic, non-specific inflammatory condition affecting the aorta and its primary branches. In addition to arterial stenosis, some affected vessels exhibit dilatation or aneurysmal changes. The etiology and pathogenesis of Takayasu's arteritis remain unclear, and the disease typically manifests with a relatively slow onset. This type of medication is primarily therapeutic, and the prognosis is generally favorable. In this report, we present a case involving a 21-year-old female patient diagnosed with Takayasu Arteritis (TAK), who exhibited unexplained, residual, painless, intermittent hematuria over a period of two years. This condition culminated in a severe outcome characterized by the sudden onset of pulmonary embolism and cerebral infarction. Case presentation A 21-year-old female patient experienced a sudden episode of syncope and loss of consciousness during a brief journey. Digital subtraction angiography revealed the presence of acute cerebral infarction, pulmonary embolism, and multiple large artery stenoses. The patient had a two-year history of painless hematuria, the etiology of which remained undetermined despite routine diagnostic evaluations. In accordance with the 2022 American College of Rheumatology/EULAR classification criteria, TAK was considered for this patient. Following hospital admission, the patient underwent an urgent embolectomy; however, the prognosis remained unfavorable. Conclusions In cases of young women presenting with painless hematuria where routine examinations do not reveal an underlying cause, it is crucial to consider the potential diagnosis of Takayasu arteritis. Early diagnosis through diagnostic imaging, particularly angiography, is vital, as it can significantly enhance patient outcomes. Asymptomatic hematuria acute cerebral infarction pulmonary embolism Takayasu Arteritis case report Figures Figure 1 Background Takayasu arteritis (TAK) is a rare form of vasculitis, and it is widely regarded by scholars as an autoimmune disease. With early diagnosis and proactive medical intervention, the condition can be effectively managed in most patients. Nevertheless, a subset of patients experiencing critical conditions such as aortic dissection, acute coronary syndrome, acute pulmonary embolism, or severe cerebrovascular disease necessitate surgical intervention to preserve life, safeguard organ function, and enhance both survival rates and overall prognosis. In this particular case, the initial clinical manifestation of TAK is characterized by intermittent painless hematuria. TAK, a prominent form of pan-arteritis, is a chronic granulomatous inflammatory disorder that primarily affects the aorta and its major branches. It is predominantly observed in young women, with the highest prevalence occurring in individuals aged 16 to 34 years. This rare disease presents with a range of clinical manifestations, most commonly asymptomatic vascular weakening, fatigue, headache, and occasionally severe neurological complications. 2 With the widespread adoption of angiography, the reported incidence of TAK has been rising annually. Case Report A 21-year-old female college student, while on a brief excursion away from campus, unexpectedly collapsed on the platform and lost consciousness. During transit in the ambulance, the patient was observed to be in a profound coma, exhibiting anisocoria without any convulsions or incontinence, and airway management was undertaken. Subsequently, computed tomography (CT) scan of the head, chest, and abdomen showed no significant abnormalities were detected. Arterial blood gas analysis indicated type 1 respiratory failure accompanied by metabolic acidosis, while a bedside focused assessment with sonography for trauma (FSAT) revealed right heart enlargement. Enhanced angiography of the head, neck, and pulmonary arteries indicated occlusions in the distal Superior Cerebellar Artery and bilateral Posterior Cerebral Arteries at the origin of the Basilar Artery. Additionally, a segmental occlusion was observed in the left Anterior Cerebral Artery at the distal end of the A2 segment (Fig. 1 -A). And, extensive pulmonary embolism was detected in the distal portion of the main pulmonary trunk (Fig. 1 -B). Furthermore, the lumens of the celiac trunk, splenic artery, common hepatic artery, and bilateral external iliac artery appeared narrowed (Fig. 1 -C). In accordance with the 2022 American College of Rheumatology/EULAR classification criteria, TAK was considered for this patient. 1 The patient's family member disclosed that the patient had experienced recurrent episodes of intermittent painless hematuria over the past two years without cause. One week ago, the patient underwent percutaneous renal angiography, and no hemorrhagic lesions or renal artery stenosis. Due to the patient's recent surgical history, pulmonary arteriography was conducted, over 30 dark red thrombi of varying sizes were extracted. Subsequently, global cerebral arteriography and embolectomy of the basilar artery were performed. Dark red thrombi were observed in the middle and distal segments of the basilar artery, and successful recanalization to TIMI (Thrombolysis in Myocardial Infarction) Grade 3 was achieved. A follow-up CT revealed a reduction in the density of the bilateral cerebral hemispheres and brainstem. Consequently, bilateral craniotomy decompression was performed, yet the patient continued to lack spontaneous respiration. Discussion and Conclusions Existing research indicates that patients with TAK generally exhibit a favorable prognosis on a global scale. Nevertheless, it is imperative that TAK patients be vigilantly monitored for stroke incidence, irrespective of age. 3 Study indicated that patients with TAK exhibited an elevated risk of developing coronary artery disease, stroke, transient cerebral ischemia, cardiovascular disease, and peripheral artery disease. 4 And, patients with TAK commonly exhibited severe hemodynamic instability and organ dysfunction upon the diagnosis of pulmonary hypertension. Concurrently, factors identified as predictors of heightened all-cause mortality risk included syncope, elevated levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), and increased mean right atrial pressure. 5 At the time of onset, the patient exhibited hemodynamic instability and right heart enlargement, and despite active intervention, the prognosis remained poor. Consequently, the severity of vascular-related complications serves as a significant prognostic factor in such cases. 6 The patient presented with a history of recurrent, intermittent, painless hematuria two years prior to onset, though the etiology remained undetermined. Research indicates that TAK can induce glomerular disease even in the absence of renal artery stenosis, a phenomenon that is not uncommon. 7 The typical clinical presentations of glomerular involvement include hematuria and mild to moderate proteinuria, often accompanied by normal or slightly elevated serum creatinine levels. Both TAK and glomerulonephritis are diseases mediated by the immune system. Hematuria and proteinuria, with or without mild renal dysfunction, are frequently observed clinical manifestations. 8 Unfortunately, renal biopsy was not performed in this patient, resulting in a lack of direct diagnostic evidence. Consequently, TAK should be considered a potential diagnosis in young female patients presenting with unexplained hematuria or proteinuria. Prompt intervention in these cases can substantially enhance the effectiveness of treatment. Declarations Ethics declaration：not applicable. Patient Consent：Consent for publication was obtained from the patient. Support: None. Financial Disclosure: The authors declare that they have no relevant financial interests. Conflict of interest statement: We declare that we have no conflict of interest. Consent for publication: Consent for publication was obtained from all of the participants. And all authors have seen and approved the manuscript for submission. Data availability statements: All data generated during this study are included in this published article. Author Contribution Zhou Juan wrote the main manuscript text and prepared figures 1, Ao Haijiao provided resources and analyze data,Zhang Lu and Liu Yang were jointly responsible for the supervision and management of article revision. All authors reviewed the manuscript. References Grayson PC, Ponte C, Suppiah R, et al. 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis. Ann Rheum Dis BMJ Publishing Group Ltd. 2022;81:1654–60. Setty HSN, Rao M, Srinivas KH, et al. Clinical, angiographic profile and percutaneous endovascular management of Takayasu’s arteritis - A single centre experience. Int J Cardiol. 2016;220:924–8. Ahn SS, Han M, Park Y-B, Jung I, Lee S-W. Incidence, prevalence and risk of stroke in patients with Takayasu arteritis: a nationwide population-based study in South Korea. Stroke Vasc Neurol. 2021;7:149–57. Goel R, Chandan JS, Thayakaran R, Adderley NJ, Nirantharakumar K, Harper L. Cardiovascular and Renal Morbidity in Takayasu Arteritis: A Population-Based Retrospective Cohort Study From the United Kingdom. Arthritis Rheumatol Hoboken NJ. 2021;73:504–11. Jiang X, Zhu Y-J, Zhou Y-P, et al. Clinical features and survival in Takayasu’s arteritis-associated pulmonary hypertension: a nationwide study. Eur Heart J. 2021;42:4298–305. Jagtap S, Mishra P, Rathore U et al. Increased mortality rate in Takayasu arteritis is largely driven by cardiovascular disease-a cohort study. Rheumatol Oxf Engl 2023;kead584. De Pablo P, García-Torres R, Uribe N, et al. Kidney involvement in Takayasu arteritis. Clin Exp Rheumatol. 2007;25:S10–14. Chen Z, Li J, Yang Y, et al. The renal artery is involved in Chinese Takayasu’s arteritis patients. Kidney Int Elsevier. 2018;93:245–51. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6598093","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":470394908,"identity":"85babf59-940b-4e83-8803-b2d6369c7206","order_by":0,"name":"Zhou Juan","email":"","orcid":"","institution":"Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","correspondingAuthor":false,"prefix":"","firstName":"Zhou","middleName":"","lastName":"Juan","suffix":""},{"id":470394909,"identity":"bdfc1d37-6154-4ca5-b236-381e07ad1aae","order_by":1,"name":"Ao Haijiao","email":"","orcid":"","institution":"Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","correspondingAuthor":false,"prefix":"","firstName":"Ao","middleName":"","lastName":"Haijiao","suffix":""},{"id":470394912,"identity":"ab790d81-af84-4c84-9f1d-5ccd9dd778c5","order_by":2,"name":"Zhang Lu","email":"","orcid":"","institution":"Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","correspondingAuthor":false,"prefix":"","firstName":"Zhang","middleName":"","lastName":"Lu","suffix":""},{"id":470394913,"identity":"4ed17d7d-c887-4948-ad8f-dbf5c640fa8a","order_by":3,"name":"Liu Yang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3ElEQVRIiWNgGAWjYBACPmYILWcgAWEwNhDSwgbVYkyCFiiduIF4Lew8ZhI/d9Smb5fuMfz4g8FGdsMB5mcP8DuMx0yy98zx3J1zzhhL8zCkGW84wGZuQEiLBG/bsdwNN3IMpBkYDiduOMDDJkHQlr9tx9INbuQY//zB8J84LdK8bTUJQC1mEjwMB4jRwlZsLdt2wHDDnWNl1jwGycYzD7OZ4dXCz3944823bXXyBrebN9/8UWEn23e8+RleLUDAAlRwGMoGBRUzAfUgJR8YGOoIKxsFo2AUjIKRCwBNt0NP/vrbnAAAAABJRU5ErkJggg==","orcid":"","institution":"Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","correspondingAuthor":true,"prefix":"","firstName":"Liu","middleName":"","lastName":"Yang","suffix":""}],"badges":[],"createdAt":"2025-05-06 02:08:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6598093/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6598093/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84670718,"identity":"7c22a7f2-a3bf-4d60-9a10-8e7920c7f582","added_by":"auto","created_at":"2025-06-16 06:38:48","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":438517,"visible":true,"origin":"","legend":"\u003cp\u003ePresents the patient's angiographic schematic. A Illustrating occlusion in the initial segment of the posterior cerebral artery, accompanied by poor distal visualization. B Showing extensive embolization in the distal portion of the main pulmonary trunk, as well as in the bilateral pulmonary trunk and its branches. C Indicating that the lumens of the celiac trunk, splenic artery, common hepatic artery, and bilateral external iliac arteries are intact.\u003c/p\u003e","description":"","filename":"F1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6598093/v1/2a57a00d3f3d790071211e15.jpg"},{"id":86713797,"identity":"3718e89b-af30-4d55-b367-d620fc6b6f28","added_by":"auto","created_at":"2025-07-14 19:46:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":716638,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6598093/v1/3128aeb7-f9f1-4854-b739-a6fb9f81b67b.pdf"},{"id":84669888,"identity":"e6a35aeb-55a5-466c-96d7-ae1b23fcc7b3","added_by":"auto","created_at":"2025-06-16 06:30:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":1368924,"visible":true,"origin":"","legend":"","description":"","filename":"CAREchecklistEnglish2013.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6598093/v1/fe0d9584185fe6fcd1e13dd4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Acute Onset of Consciousness Disturbance in a Young Patient Presenting with Asymptomatic Hematuria: A case report","fulltext":[{"header":"Background","content":"\u003cp\u003eTakayasu arteritis (TAK) is a rare form of vasculitis, and it is widely regarded by scholars as an autoimmune disease. With early diagnosis and proactive medical intervention, the condition can be effectively managed in most patients. Nevertheless, a subset of patients experiencing critical conditions such as aortic dissection, acute coronary syndrome, acute pulmonary embolism, or severe cerebrovascular disease necessitate surgical intervention to preserve life, safeguard organ function, and enhance both survival rates and overall prognosis. In this particular case, the initial clinical manifestation of TAK is characterized by intermittent painless hematuria. TAK, a prominent form of pan-arteritis, is a chronic granulomatous inflammatory disorder that primarily affects the aorta and its major branches. It is predominantly observed in young women, with the highest prevalence occurring in individuals aged 16 to 34 years. This rare disease presents with a range of clinical manifestations, most commonly asymptomatic vascular weakening, fatigue, headache, and occasionally severe neurological complications.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e With the widespread adoption of angiography, the reported incidence of TAK has been rising annually.\u003c/p\u003e"},{"header":"Case Report","content":"\u003cp\u003eA 21-year-old female college student, while on a brief excursion away from campus, unexpectedly collapsed on the platform and lost consciousness. During transit in the ambulance, the patient was observed to be in a profound coma, exhibiting anisocoria without any convulsions or incontinence, and airway management was undertaken. Subsequently, computed tomography (CT) scan of the head, chest, and abdomen showed no significant abnormalities were detected. Arterial blood gas analysis indicated type 1 respiratory failure accompanied by metabolic acidosis, while a bedside focused assessment with sonography for trauma (FSAT) revealed right heart enlargement. Enhanced angiography of the head, neck, and pulmonary arteries indicated occlusions in the distal Superior Cerebellar Artery and bilateral Posterior Cerebral Arteries at the origin of the Basilar Artery. Additionally, a segmental occlusion was observed in the left Anterior Cerebral Artery at the distal end of the A2 segment (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e-A). And, extensive pulmonary embolism was detected in the distal portion of the main pulmonary trunk (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e-B). Furthermore, the lumens of the celiac trunk, splenic artery, common hepatic artery, and bilateral external iliac artery appeared narrowed (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e-C). In accordance with the 2022 American College of Rheumatology/EULAR classification criteria, TAK was considered for this patient.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e The patient's family member disclosed that the patient had experienced recurrent episodes of intermittent painless hematuria over the past two years without cause. One week ago, the patient underwent percutaneous renal angiography, and no hemorrhagic lesions or renal artery stenosis.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eDue to the patient's recent surgical history, pulmonary arteriography was conducted, over 30 dark red thrombi of varying sizes were extracted. Subsequently, global cerebral arteriography and embolectomy of the basilar artery were performed. Dark red thrombi were observed in the middle and distal segments of the basilar artery, and successful recanalization to TIMI (Thrombolysis in Myocardial Infarction) Grade 3 was achieved. A follow-up CT revealed a reduction in the density of the bilateral cerebral hemispheres and brainstem. Consequently, bilateral craniotomy decompression was performed, yet the patient continued to lack spontaneous respiration.\u003c/p\u003e "},{"header":"Discussion and Conclusions","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003cp\u003eExisting research indicates that patients with TAK generally exhibit a favorable prognosis on a global scale. Nevertheless, it is imperative that TAK patients be vigilantly monitored for stroke incidence, irrespective of age.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e Study indicated that patients with TAK exhibited an elevated risk of developing coronary artery disease, stroke, transient cerebral ischemia, cardiovascular disease, and peripheral artery disease. \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e And, patients with TAK commonly exhibited severe hemodynamic instability and organ dysfunction upon the diagnosis of pulmonary hypertension. Concurrently, factors identified as predictors of heightened all-cause mortality risk included syncope, elevated levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), and increased mean right atrial pressure. \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e At the time of onset, the patient exhibited hemodynamic instability and right heart enlargement, and despite active intervention, the prognosis remained poor. Consequently, the severity of vascular-related complications serves as a significant prognostic factor in such cases. \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe patient presented with a history of recurrent, intermittent, painless hematuria two years prior to onset, though the etiology remained undetermined. Research indicates that TAK can induce glomerular disease even in the absence of renal artery stenosis, a phenomenon that is not uncommon. \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e The typical clinical presentations of glomerular involvement include hematuria and mild to moderate proteinuria, often accompanied by normal or slightly elevated serum creatinine levels. Both TAK and glomerulonephritis are diseases mediated by the immune system. Hematuria and proteinuria, with or without mild renal dysfunction, are frequently observed clinical manifestations. \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e Unfortunately, renal biopsy was not performed in this patient, resulting in a lack of direct diagnostic evidence. Consequently, TAK should be considered a potential diagnosis in young female patients presenting with unexplained hematuria or proteinuria. Prompt intervention in these cases can substantially enhance the effectiveness of treatment.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics declaration：not applicable.\u003c/p\u003e\n\u003cp\u003ePatient Consent：Consent for publication was obtained from the patient.\u003c/p\u003e\n\u003cp\u003eSupport: None.\u003c/p\u003e\n\u003cp\u003eFinancial Disclosure: The authors declare that they have no relevant financial interests.\u003c/p\u003e\n\u003cp\u003eConflict of interest statement: We declare that we have no conflict of interest.\u003c/p\u003e\n\u003cp\u003eConsent for publication: Consent for publication was obtained from all of the participants. And all authors have seen and approved the manuscript for submission.\u003c/p\u003e\n\u003cp\u003eData availability statements: All data generated during this study are included in this published article.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eZhou Juan wrote the main manuscript text and prepared figures 1, Ao Haijiao provided resources and analyze data,Zhang Lu and Liu Yang were jointly responsible for the supervision and management of article revision. All authors reviewed the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGrayson PC, Ponte C, Suppiah R, et al. 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis. Ann Rheum Dis BMJ Publishing Group Ltd. 2022;81:1654\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSetty HSN, Rao M, Srinivas KH, et al. Clinical, angiographic profile and percutaneous endovascular management of Takayasu\u0026rsquo;s arteritis - A single centre experience. Int J Cardiol. 2016;220:924\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAhn SS, Han M, Park Y-B, Jung I, Lee S-W. Incidence, prevalence and risk of stroke in patients with Takayasu arteritis: a nationwide population-based study in South Korea. Stroke Vasc Neurol. 2021;7:149\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoel R, Chandan JS, Thayakaran R, Adderley NJ, Nirantharakumar K, Harper L. Cardiovascular and Renal Morbidity in Takayasu Arteritis: A Population-Based Retrospective Cohort Study From the United Kingdom. Arthritis Rheumatol Hoboken NJ. 2021;73:504\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJiang X, Zhu Y-J, Zhou Y-P, et al. Clinical features and survival in Takayasu\u0026rsquo;s arteritis-associated pulmonary hypertension: a nationwide study. Eur Heart J. 2021;42:4298\u0026ndash;305.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJagtap S, Mishra P, Rathore U et al. Increased mortality rate in Takayasu arteritis is largely driven by cardiovascular disease-a cohort study. Rheumatol Oxf Engl 2023;kead584.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe Pablo P, Garc\u0026iacute;a-Torres R, Uribe N, et al. Kidney involvement in Takayasu arteritis. Clin Exp Rheumatol. 2007;25:S10\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen Z, Li J, Yang Y, et al. The renal artery is involved in Chinese Takayasu\u0026rsquo;s arteritis patients. Kidney Int Elsevier. 2018;93:245\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Asymptomatic hematuria, acute cerebral infarction, pulmonary embolism, Takayasu Arteritis, case report","lastPublishedDoi":"10.21203/rs.3.rs-6598093/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6598093/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eTakayasu's arteritis is characterized as a chronic, non-specific inflammatory condition affecting the aorta and its primary branches. In addition to arterial stenosis, some affected vessels exhibit dilatation or aneurysmal changes. The etiology and pathogenesis of Takayasu's arteritis remain unclear, and the disease typically manifests with a relatively slow onset. This type of medication is primarily therapeutic, and the prognosis is generally favorable. In this report, we present a case involving a 21-year-old female patient diagnosed with Takayasu Arteritis (TAK), who exhibited unexplained, residual, painless, intermittent hematuria over a period of two years. This condition culminated in a severe outcome characterized by the sudden onset of pulmonary embolism and cerebral infarction.\u003c/p\u003e\u003ch2\u003eCase presentation\u003c/h2\u003e \u003cp\u003eA 21-year-old female patient experienced a sudden episode of syncope and loss of consciousness during a brief journey. Digital subtraction angiography revealed the presence of acute cerebral infarction, pulmonary embolism, and multiple large artery stenoses. The patient had a two-year history of painless hematuria, the etiology of which remained undetermined despite routine diagnostic evaluations. In accordance with the 2022 American College of Rheumatology/EULAR classification criteria, TAK was considered for this patient. Following hospital admission, the patient underwent an urgent embolectomy; however, the prognosis remained unfavorable.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIn cases of young women presenting with painless hematuria where routine examinations do not reveal an underlying cause, it is crucial to consider the potential diagnosis of Takayasu arteritis. Early diagnosis through diagnostic imaging, particularly angiography, is vital, as it can significantly enhance patient outcomes.\u003c/p\u003e","manuscriptTitle":"Acute Onset of Consciousness Disturbance in a Young Patient Presenting with Asymptomatic Hematuria: A case report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-16 06:30:43","doi":"10.21203/rs.3.rs-6598093/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"66f7c736-e853-4bd3-91e9-799e88585905","owner":[],"postedDate":"June 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-14T19:38:20+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-16 06:30:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6598093","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6598093","identity":"rs-6598093","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}