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Brachial plexopathy as a complication of axillary artery aneurysm in a case of Takayasu arteritis
  1. Anjum Siddiqui,
  2. Parag Vijayvergia,
  3. Kriti Kishor and
  4. Puneet Kumar
  1. Clinical Immunology and Rheumatology, King George Medical University, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Kriti Kishor; kritikishor{at}gmail.com

Abstract

Takayasu arteritis is an inflammatory disease of unknown aetiology affecting large vessels. Medium vessel involvement is also well documented; however, neuropathy as a presenting manifestation is rare. In this case report, a young woman in her 20s presented with an 8-month history of intermittent claudication in the right upper limb progressing to rest pain with allodynia in C5–C8 distribution and painless right axillary mass. On examination, she had absent pulses in the right radial, brachial and subclavian artery with audible bruit in the right subclavian and abdominal aorta. CT angiogram showed features suggestive of Takayasu arteritis with a partially thrombosed aneurysm arising from the right axillary artery leading to compression of the right brachial plexus. This patient received treatment with methotrexate and oral corticosteroids. At 3 months follow-up, there was a reduction in the size of the aneurysm, resolution of compressive symptoms and normalisation of inflammatory markers.

  • Vasculitis
  • Arteries
  • Autoimmunity
  • Cardiovascular medicine

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Footnotes

  • X @paragvijay95, @kriti_lhmc

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: AS, PV, KK and PK. The following authors gave final approval of the manuscript: AS, PV, KK and PK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.