An Atypical Presentation of Takayasu Arteritis: Isolated Tinnitus Followed by Ectopic Pregnancy.

Takayasu arteritis (TA) is a chronic large-vessel vasculitis that may present with a broad spectrum of clinical manifestations, some of which are subtle or atypical. Otologic symptoms are not commonly emphasized in this context, yet in some cases, they may precede more overt systemic findings, as illustrated in this report. We report a case of a 41-year-old female whose initial symptom was bilateral pulsatile tinnitus, occurring in the absence of hearing loss or audiometric abnormalities. In this patient, the tinnitus persisted for approximately five or six months before the onset of systemic complaints. Serial imaging over time revealed progressive, multi-territorial vascular involvement consistent with TA. Her treatment course included long-term corticosteroid therapy, which was complicated by an ectopic pregnancy requiring coordinated interdisciplinary care. This case highlights the potential relevance of isolated otologic symptoms as an early clinical clue in systemic vasculitis. Such atypical presentations can make the diagnosis more challenging and contribute to delays in treatment. It also underscores the importance of comprehensive management, including reproductive counseling for women of childbearing age and ongoing surveillance.