Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Key clinical features to consider when diagnosing Takayasu arteritis in a young adult include:
- Constitutional symptoms: Patients often present with systemic features such as fever, malaise, weight loss, and fatigue, reflecting the inflammatory nature of the disease NICE CKS Somashekar & Leung 2023.
- Vascular symptoms and signs: These include limb claudication (especially upper limbs), diminished or absent peripheral pulses, blood pressure discrepancies between arms, and bruits over large arteries such as carotid or subclavian arteries NICE CKS Bhandari et al. 2023.
- Hypertension: Secondary hypertension is common due to renal artery involvement or aortic coarctation NICE CKS Millan et al. 2022.
- Neurological symptoms: Dizziness, syncope, or visual disturbances may occur due to carotid or vertebral artery involvement NICE CKS Somashekar & Leung 2023.
- Arterial inflammation signs: Tenderness or pain over affected arteries, and in some cases, features of ischemia such as ulcers or gangrene in severe disease NICE CKS Bhandari et al. 2023.
- Laboratory findings: Elevated inflammatory markers such as ESR and CRP support the diagnosis but are nonspecific NICE CKS Somashekar & Leung 2023.
In summary, the diagnosis in a young adult relies on recognizing a combination of systemic inflammatory symptoms and characteristic large-vessel ischemic signs, supported by laboratory and imaging findings NICE CKS Millan et al. 2022Somashekar & Leung 2023Bhandari et al. 2023.
Key References
- CKS - Giant cell arteritis
- NG143 - Fever in under 5s: assessment and initial management
- NG65 - Spondyloarthritis in over 16s: diagnosis and management
- (Millan et al., 2022): Childhood-onset Takayasu arteritis.
- (Somashekar and Leung, 2023): Updates in the diagnosis and management of Takayasu's arteritis.
- (Bhandari et al., 2023): Pathophysiology, Diagnosis, and Management of Takayasu Arteritis: A Review of Current Advances.