A 28-year-old Indian woman presents with claudication of both upper limbs. The right radial pulse is absent, blood pressure differs by 40 mmHg between arms, and a bruit is audible over the left supraclavicular fossa. ESR is 68 mm/hr. Which is the most likely diagnosis?

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

Explanation

Takayasu arteritis is a granulomatous panarteritis of the aorta and its major branches, classically affecting women under 40 years in Asia. Upper limb claudication, pulse asymmetry or absence, subclavian bruits and raised inflammatory markers are typical. Thromboangiitis obliterans occurs in young male smokers and affects distal limb vessels, not the aortic arch. Giant cell arteritis is a disease of patients over 50 years.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.