Which vasculitis is known as pulseless disease because of diminished upper-extremity pulses?

Which vasculitis is known as pulseless disease because of diminished upper-extremity pulses?

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

Answer: (B)

The pattern tested is a large-vessel vasculitis that narrows the major arteries supplying the arms. Takayasu arteritis inflames the aorta and its branches, especially the subclavian and brachiocephalic arteries, leading to stenosis and reduced or absent pulses in the upper extremities. This “pulseless” presentation often comes with differences in blood pressure between arms, limb claudication, and audible bruits, and it typically affects young women, with higher prevalence in Asia. Giant cell arteritis tends to occur in older adults and involves the temporal arteries and branches of the carotids, causing headaches, scalp tenderness, and vision issues rather than classic upper-extremity pulse loss. Kawasaki disease is a pediatric condition that mainly affects medium-sized arteries, notably the coronary arteries, with mucocutaneous signs rather than prominent arm pulse deficits. Polyarteritis nodosa involves medium-sized arteries and presents with systemic signs, abdominal pain, neuropathy, or renal involvement rather than the specific pulseless upper-extremity pattern. So the description of diminished upper-extremity pulses defining a pulseless disease points to Takayasu arteritis.

The pattern tested is a large-vessel vasculitis that narrows the major arteries supplying the arms. Takayasu arteritis inflames the aorta and its branches, especially the subclavian and brachiocephalic arteries, leading to stenosis and reduced or absent pulses in the upper extremities. This “pulseless” presentation often comes with differences in blood pressure between arms, limb claudication, and audible bruits, and it typically affects young women, with higher prevalence in Asia.

Giant cell arteritis tends to occur in older adults and involves the temporal arteries and branches of the carotids, causing headaches, scalp tenderness, and vision issues rather than classic upper-extremity pulse loss. Kawasaki disease is a pediatric condition that mainly affects medium-sized arteries, notably the coronary arteries, with mucocutaneous signs rather than prominent arm pulse deficits. Polyarteritis nodosa involves medium-sized arteries and presents with systemic signs, abdominal pain, neuropathy, or renal involvement rather than the specific pulseless upper-extremity pattern.

So the description of diminished upper-extremity pulses defining a pulseless disease points to Takayasu arteritis.