Vol.3, No.3, 159-161 (2011) Health doi:10.4236/health.2011.33030 Copyright © 2011 SciRes. Openly accessible at http://www.scirp.org/journal/HEALTH/ Mycobacterium tuberculosis in the aorta of a patient with takayasu’s arteritis. extra pulmonary tuberculosis María Elena Soto, Virgilia Soto, Julia Isela Martín Sandría, Ricardo Gamboa, Claudia Huesca Immunology and Physiology Departament, Juan Badiano #1 Colonia Sección XVI, Tlalpan México, D. F, México., *Corresponding Author: virgiliasoto@gmail.com ; Received 15 October 2010; revised 2 December 2010; accepted 11 January 2011. ABSTRACT Takayasu’s arteritis (TA), of unknown etiology, has been related with Mycobacterium tubercu- losis infection. The published cases are con- troversial. A 29- year-old man died, prolapse of the aortic valve and unspecific arteritis were demonstrated at necropsy. Our objective was to search in the fresh aortic tissues, the infectious agent of tuberculosis through culture, as well as by performing histopathology and searching by the molecular study, sequences of genes asso- ciated to mycobacterium and Ziehl’s stain. Re- sults. The bacillus of tuberculosis was observed by the Ziehl’s stain and the sequences of inser- tion IS6110 gene were identified. Our findings support the relation of TA with possible tuber- culosis infection.Conclusion. The possibility that Takayasu’s arteritis is an extra pulmonary tuberculosis must be explored. Keywords: Takayasu’s arteritis, extrapulmonary tuberculosis, IS6110 and HupB sequences. 1. INTRODUCTION Takayasu’s arteritis (TA) is a chronic inflammatory disease affecting the large arteries and their branches [1]. Pathology is localized in the adventitia, accompanied by mononuclear infiltration and undefined granulomas; the intimae is usually normal but becomes altered in time due to atherosclerosis [2]. TA has been related to Mycobacterium tuberculosis infection, arterial damage depicts granulomatous lesions similar to those of tissues with tuberculosis [3,4] and hyperreactivity to tuberculin application has been docu- mented [5,6,7,8].The published cases are controversial [9,10,11]. We describe an autopsy case, in which unspecific ar- teritis was found. We searched for tuberculous infection. 2. DESCRIPTION OF THE CASE A 29-year-old man, without previous symptoms of tu- berculosis or symptoms relevant to the current illness. No relative with tuberculosis was informed during questioning; no BCG vaccination had been applied to the patient. Three years before, the patient had referred pain in both legs when exerting physically and he had occasional headaches. High blood pressure had been detected in three previous occasions, but he received no antihypertensive treatment. During indirect questioning, relatives informed that, an hour before his admittance to the hospital, he had com- plained of an intense oppressive pain in the chest and upper abdomen, pain irradiating to both arms and neck, with difficulty to breath, generalized pulsed headache, and hemoptysis, he seemed disoriented. Physical exploration revealed a hypertensive crisis, blood pressure of 200/120 mmHg, diaphoresis, we found it confused in time space and person; neck with yugular ingurgitation grade I and murmur in aortic focus the left supraclavicular region, pulseless in the left arm. He pre- sented cardiorespiratory failure half an hour after his admittance, which did not revert with maneuvers of re- suscitation. Autopsy was performed by an expert pa- thologist, finding histopathological data of Takayasu’s arteritis. The case was commented with the rheumatologist, who analyzed the post-mortem clinical file. Demographic data recorded at his arrival at the emergency ward were: age below 40 years, absence of pulse, aortic murmur irra- diated to the neck, history of claudication in the lower extremities, these data, provides four clinical criteria, for classification of TA and the autopsy findings which are the gold standard for Takayasu’s arteritis diagnosis. Tissue samples were taken for DNA studies, searching for sequences of the IS6110 gene associated to Myco- bacterium tuberculosis. Samples were stains with hema- toxylin-eosin, Schiff (periodic acid, PAS), Mason’s trichrome, auramine-rhodamine, and Ziehl-Neelsen. Ziehl-Neelsen stained and microscopically analyzed.