A patient with fever and fatigue has a weak pulse in the upper extremities; which vasculitis is most likely?

A patient with fever and fatigue has a weak pulse in the upper extremities; which vasculitis is most likely?

• A. Giant cell arteritis
• B. Takayasu arteritis
• C. Polyarteritis nodosa
• D. Kawasaki disease

Answer: (B)

The key idea is a large-vessel vasculitis affecting the aorta and its major branches, leading to reduced blood flow to the arms. Takayasu arteritis attacks the vessels supplying the upper body, causing weak or absent pulses in the upper extremities and often a fever with fatigue. This pattern—systemic inflammation plus arm pulse discrepancies—fits best with Takayasu arteritis. In contrast, giant cell arteritis occurs in older adults with temporal headaches and vision issues; polyarteritis nodosa affects medium-sized vessels and presents with abdominal pain, renal involvement, or hypertension; Kawasaki disease is a pediatric illness with mucocutaneous findings and coronary artery problems.

The key idea is a large-vessel vasculitis affecting the aorta and its major branches, leading to reduced blood flow to the arms. Takayasu arteritis attacks the vessels supplying the upper body, causing weak or absent pulses in the upper extremities and often a fever with fatigue. This pattern—systemic inflammation plus arm pulse discrepancies—fits best with Takayasu arteritis. In contrast, giant cell arteritis occurs in older adults with temporal headaches and vision issues; polyarteritis nodosa affects medium-sized vessels and presents with abdominal pain, renal involvement, or hypertension; Kawasaki disease is a pediatric illness with mucocutaneous findings and coronary artery problems.