Searching for Clues to Fever of Unknown Origin

A 13-year-old adolescent girl of Greek descent presented with fever of unknown origin and arthralgias of wrists and ankles 3 weeks following vacationing in Greece. On the initial physical examination there were no signs of arthritis and the neurologic signs were normal. On the outpatient follow-up, fever and arthralgia persisted and pedal pulses were absent. Magnetic resonance angiography (MRA) showed irregular narrowing of the iliac arteries. The diagnosis of Takayasu's arteritis was made and the symptoms improved rapidly with prednisone.