A 24-year-old woman presents with 4 months of left arm claudication when combing her hair. Blood pressure is 160/90 mmHg in the right arm and unrecordable in the left arm. There are audible bruits over both carotid arteries and the abdominal aorta. ESR is 72 mm/hr. What is the most likely diagnosis?

• A Takayasu arteritis ✓
• B Giant cell arteritis
• C Thromboangiitis obliterans
• D Behcet disease

Explanation

Takayasu arteritis is a granulomatous large-vessel arteritis of the aorta and its major branches, classically affecting women under 40 years of age. Upper limb claudication, asymmetric arm blood pressures, arterial bruits, and a raised ESR are typical. Giant cell arteritis produces an identical histology but is excluded by age, since it virtually never occurs before 50 years. Thromboangiitis obliterans affects small and medium vessels of distal limbs in young male smokers, and Behcet disease causes venous thrombosis and uveitis rather than aortic branch stenosis.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.