Abstract
Takayasu arteritis（ TA） and ulcerative colitis（ UC） share many genetic factors, and coexistence of
both are not uncommon. We report a case of TA in a 11-year-old girl with UC.
She developed total colonic UC at the age of 8. While being treated with azathioprine （AZA） and
infliximab （IFX）, pain in the interior thigh during exercise and increased CRP were observed from age 11
years and 2 months old. No exacerbation of UC was found in colonoscopy at that time. Subsequently, pyrexia
and malaise developed, and PET-CT showed accumulation in both subclavian arteries, leading to the
diagnosis of TA. Methylprednisolone pulse therapy was performed and the dose of AZA was increased as an
induction therapy. IFX was continued every 6 weeks. The vascular ultrasound findings worsened as the
dose of PSL was tapered and IFX was changed to tocilizumab（ TCZ） at the age of 12 years and 1 months.
Thereafter, UC exacerbated and total colectomy was performed at the age of 12 years and 7 months. After
the operation, vascular ultrasound findings improved and PSL is being tapered without relapse.
TCZ is considered for maintenance therapy in PSL dependent TA patients, but efficacy of TCZ in
UC is unclear. Since the overlap of TA and UC is not uncommon, it is necessary to seek the optimum
treatment for TA with UC in the future.
