A 30-year-old male represents with numbness of both lower limbs and right upper limbs Examination reveals pulse 88/mm and BP 16/110 mmHg. He also has digital gangrene involving right 2nd and 3rd finger, urine routine examination is unremarkable. Microscopic examination show RBCs, hemogram and serum biochemistru is within normal limits.What is most probable diagnosis?

## **Core Concept**
The patient's presentation suggests a systemic vasculitis affecting multiple limbs, indicated by numbness, digital gangrene, and elevated blood pressure. The presence of RBCs in the urine and normal hemogram and serum biochemistry point towards a condition that affects blood vessels.

## **Why the Correct Answer is Right**
The clinical picture of limb ischemia (numbness and digital gangrene), hypertension, and renal involvement (RBCs in urine) is highly suggestive of **Takayasu Arteritis**. This large vessel vasculitis primarily affects the aorta and its major branches, leading to symptoms due to ischemia in the affected areas. The condition commonly presents in young women but can occur in men as well.

## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is blank and cannot be evaluated.
- **Option B:** This option is blank and cannot be evaluated.
- **Option C:** This option is blank and cannot be evaluated.
- **Option D:** This option is blank and cannot be evaluated.

## **Clinical Pearl / High-Yield Fact**
A key clinical pearl in this case is that Takayasu Arteritis often presents with **"burned-out"** or absent pulses in the affected limbs due to stenosis or occlusion of the arteries, which aligns with the patient's presentation of pulse 88/mm and BP 110/160 mmHg, indicating possible differential blood pressure readings in different limbs.

## **Correct Answer:** C. Takayasu arteritis.

✓ Correct Answer: B. Polyaeritis nodosa