Takayasu arteritis and giant cell arteritis (GCA) are both granulomatous large-vessel vasculitides. A distinguishing feature that helps differentiate Takayasu from GCA pathologically is:
- A Takayasu shows fibrinoid necrosis; GCA shows only lymphocytic infiltration
- B Takayasu is associated with ANCA; GCA is associated with anti-GBM antibodies
- C Takayasu affects the aorta and branches exclusively in patients <40 years; GCA targets temporal arteries in patients >50 years, and both show granulomas in the media ✓
- D Takayasu exclusively involves veins; GCA exclusively involves arteries
Explanation
Both Takayasu arteritis and GCA are granulomatous panarteritides with histologically similar features (lymphoplasmacytic and granulomatous inflammation with giant cells in the media and adventitia). The key distinguishing features are clinical and demographic: Takayasu arteritis (also called 'pulseless disease' or aortic arch syndrome) presents in women <40 years (predominantly Asian), affecting the aorta and its major branches with stenosis/occlusion causing limb claudication and absent pulses. GCA predominantly affects patients >50 years (especially Northern European descent), targeting branches of the carotid artery (temporal, ophthalmic), causing headache, jaw claudication, and visual loss. Both cause elevated ESR and CRP.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.