Takayasu Syndrome
A 28-year-old female presents to the clinic with complaints of fatigue, weight loss, and intermittent pain in her left arm and legs for the past several months. She has also been experiencing headaches, dizziness, and occasional fainting spells, especially when standing up quickly. Her medical history is unremarkable, and she has no known chronic conditions. She denies any history of trauma or recent illness.
On physical examination, her blood pressure is found to be 160/90 mmHg in the right arm but 120/80 mmHg in the left arm. A carotid bruit is noted, and there is reduced peripheral pulses in both the lower extremities. Her heart rate is 88 beats per minute, and she appears well-nourished. A thorough neurological exam is normal, but she shows signs of a diminished pulse in her arms and legs.
Laboratory tests show normal renal function and no significant abnormalities in routine blood work. Further imaging, including Doppler ultrasound and angiography, reveals narrowing and irregularities in the large arteries, including the aortic arch and its major branches, consistent with Takayasu arteritis. The diagnosis of Takayasu syndrome is confirmed.
The patient is started on corticosteroids to reduce inflammation, and her blood pressure is managed with antihypertensive medications. She is referred to a rheumatologist for ongoing management and monitoring of the disease. Regular follow-up appointments are scheduled to assess for disease progression and complications.
A) Rheumatoid arthritis
B) Takayasu arteritis (Takayasu syndrome)
C) Systemic lupus erythematosus
D) Fibromuscular dysplasia
A) Decreased pulses in the arms and legs with a blood pressure discrepancy between the arms
B) Joint swelling and morning stiffness
C) Aortic valve regurgitation
D) Red, butterfly-shaped rash on the face
A) Nonsteroidal anti-inflammatory drugs (NSAIDs)
B) Corticosteroids to reduce inflammation
C) Methotrexate
D) Antiplatelet therapy
A) Chronic kidney disease due to renal artery involvement
B) Hyperthyroidism
C) Pericarditis
D) Deep vein thrombosis
Answers
- B) Takayasu arteritis (Takayasu syndrome)
- A) Decreased pulses in the arms and legs with a blood pressure discrepancy between the arms
- B) Corticosteroids to reduce inflammation
- A) Chronic kidney disease due to renal artery involvement