A 28-year-old woman has new-onset hypertension, diminished radial pulses, and constitutional symptoms. ESR is 95 mm/h. CT angiography shows wall thickening and luminal narrowing of the aortic arch and its branches. Biopsy of the aortic wall reveals granulomatous inflammation with giant cells in the media. The diagnosis is:
- A Giant cell arteritis (temporal arteritis)
- B Kawasaki disease
- C Takayasu arteritis ✓
- D Polyarteritis nodosa
Explanation
Takayasu arteritis ('pulseless disease') is a large-vessel granulomatous vasculitis predominantly affecting the aorta and its branches in women under 50 years. It causes transmural inflammation with granulomas and giant cells, leading to aortic arch and branch vessel stenosis/occlusion (absent pulses, discrepant blood pressure), hypertension (renal artery involvement), and constitutional features. Giant cell (temporal) arteritis also causes granulomatous large-vessel vasculitis but predominantly affects older individuals (>50 years) and cranial vessels. Kawasaki disease affects coronary arteries in children; PAN spares pulmonary vessels and does not involve large vessels.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.