Catching Takayasu Early: Diagnosing the "Pulseless" Disease in a Child with Palpable Pulses

Takayasu arteritis is a systemic vasculitis of large vessels that mainly involves the aorta and its branches. It normally presents in the third decade of life and is rarely seen in children. We report a case of childhood Takayasu arteritis, in a 12-year-old girl, who presented with abdominal pain and hypertension. Although all her peripheral pulses were palpable, there was a discrepancy between her upper and lower limbs' blood pressure. CT angiography revealed stenosis of the abdominal aorta, at the origin of the celiac artery and right renal artery. She was started on steroids and an antihypertensive, after which she attained remission. Five years down the line, the child has sustained remission, with no signs of disease progression. Early diagnosis of Takayasu and initiation of immunosuppression, before the onset of the classic "pulseless" phase, may contribute to improved long-term prognosis.