Question

A 12 year old boy presented with weak pulses in upper limbs. His BP was 90/60mmHg. He also had retinal haemorrhages. Most likely diagnosis is

• A. PAn
• B. Microscopic polyangiitis
• C. Takayasu arteritis
• D. HSP

Answer 1

The Correct Option is C

The scenario describes a 12-year-old boy with weak pulses in his upper limbs, blood pressure of 90/60 mmHg, and retinal hemorrhages. Based on these symptoms, we need to determine the most likely diagnosis from the provided options.

Let's analyze the symptoms:

• Weak pulses in the upper limbs: This suggests an issue with blood flow to the arms, often indicative of large vessel involvement.
• Low blood pressure: A BP reading of 90/60 mmHg is considered hypotensive, which could be related to systemic vascular issues.
• Retinal hemorrhages: These could be associated with vascular abnormalities or inflammation.

Given these symptoms, Takayasu arteritis is the most likely diagnosis because:

• It is a form of large vessel vasculitis affecting the aorta and its major branches, which can lead to weak or absent pulse in limbs, commonly referred to as "pulseless disease."
• It predominantly affects young females but can also present in young males, causing symptoms like low blood pressure and vascular abnormalities.
• Retinal hemorrhages can occur due to the vascular involvement in this condition.

Other options can be ruled out as they typically do not present with the specific combination of symptoms described, particularly the weak pulse in the upper limbs, which is characteristic of Takayasu arteritis.

Correct Diagnosis: Takayasu arteritis