4.03 Large Vessel Vasculitis

Rheumatology review for the USMLE Step 1 Exam

• Vasculitis is inflammation of blood vessels
• Vasculitis is split into three groups based on the size of blood vessels affected: large, medium, and small vessel vasculitis
• Large vessel vasculitis involves inflammation of the aorta and its main branches
• Two distinct large vessel vasculitidies: temporal (or giant cell) arteritis and takayasu arteritis
• Temporal (giant cell) arteritis primarily affects older women (>60) and the branches of the common carotid arteries
• Symptoms of temporal arteritis: jaw pain (jaw claudication), headaches, tenderness along temporal artery
• Complication of temporal arteritis: blindness
• Takayasu arteritis mostly affects young Asian women (
• Symptoms of takayasu arteritis: weak upper extremity pulse, constitutional symptoms, myalgias, skin nodules, ocular disturbances
• Both temporal arteritis and takayasu arteritis are treated with a course of steroids