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2. A case study of Takayasu arteritis

A case study of Takayasu arteritis 

Presenting Symptoms

A 65yr old female, non-smoker, presented to her GP eight weeks post colonic resection for colon cancer, with a two-week history of intermittent left arm pain radiating from the shoulder to the fingertips worsening upon exercise e.g., carrying, lifting with left arm. The patient had no previous history of PAD.

The clinical examination on the left arm demonstrated normal range of movement with no associated pain on palpation or movement. and very faint Brachial and Radial pulses with a cold left hand.

The patient’s recent blood work showed raised inflammatory markers:

  • CRP 77 (Normal range <10mg/L) and ESR 97 mm/hr. (normal range women 0-29 mm/hr.).

The GP referred the patient to the Vascular triage clinic at the John Radcliffe hospital where the patient was assessed by the Specialist Vascular Registrar who in turn referred the patient to the Vascular Studies unit for arterial duplex scan.

 

Fig 1. Left Axillary artery showed diffuse circumferential lightly echogenic disease causing a severe string like stenosis >90% stenosis (PSVR >6) PSV/EDV = 445/169cm/sec. Stenosis length was approx. 5cm long.