Which of the following vasculitides is characterized by granulomatous inflammation of medium and large arteries with a predilection for the aorta and its branches?

Question

Accepted Answer

C. Takayasu arteritis. ## Takayasu Arteritis: Large Vessel Vasculitis

**Key Point:** Takayasu arteritis is a granulomatous vasculitis affecting the aorta and its major branches, classifying it as a large-vessel vasculitis.

### Pathological Features
- **Granulomatous inflammation** with giant cells in the media and adventitia
- **Predilection sites:** Ascending aorta, aortic arch, thoracic and abdominal aorta
- **Consequence:** Progressive stenosis, occlusion, or aneurysm formation
- Predominantly affects young women (especially from Asia, Africa, Latin America)

### Comparison with Other Vasculitides

| Vasculitis | Vessel Size | Inflammation Type | Key Features |
|---|---|---|---|
| **Takayasu** | Large (aorta, branches) | Granulomatous | Aortic arch syndrome, pulse deficits |
| Polyarteritis nodosa | Medium | Necrotizing (non-granulomatous) | Spares lungs, glomeruli; HBsAg+ |
| Microscopic polyangiitis | Small | Necrotizing (ANCA+) | ANCA-positive, glomerulonephritis |
| Wegener (GPA) | Small | Granulomatous + necrotizing | Upper respiratory involvement, c-ANCA |

**High-Yield:** The hallmark of Takayasu is **granulomatous inflammation of the aorta** — this distinguishes it from necrotizing vasculitides like PAN and MPA.

**Clinical Pearl:** Takayasu arteritis is sometimes called "pulseless disease" because stenosis of subclavian arteries can obliterate radial pulses bilaterally.

![Vasculitis Syndromes diagram](https://mmcphlazjonnzmdysowq.supabase.co/storage/v1/object/public/blog-images/explanation/2949.webp)

Answer

A. Wegener granulomatosis

Answer

B. Microscopic polyangiitis

Answer

D. Polyarteritis nodosa

Which of the following vasculitides is characterized by granulomatous inflammation of medium and large arteries with a predilection for the aorta and its branches?

Explanation

Takayasu Arteritis: Large Vessel Vasculitis

Pathological Features

Comparison with Other Vasculitides

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Vasculitis	Vessel Size	Inflammation Type	Key Features
Takayasu	Large (aorta, branches)	Granulomatous	Aortic arch syndrome, pulse deficits
Polyarteritis nodosa	Medium	Necrotizing (non-granulomatous)	Spares lungs, glomeruli; HBsAg+
Microscopic polyangiitis	Small	Necrotizing (ANCA+)	ANCA-positive, glomerulonephritis
Wegener (GPA)	Small	Granulomatous + necrotizing	Upper respiratory involvement, c-ANCA