A male patient was brought to me holding two persons in very bad condition, pt was crying of severe pain in legs and whole body, I examined no pulse, I look all paper he was carrying he was treated for Takayashu disease with steroids pain killers and antihypertensives. But no relief. In arms BP Recording tried with difficulty I guess it around 300/200mm. Then I tried at thigh and calf it was around 250/170. I looked for pulse everywhere not found.
Besides all investigation RA factor and CRP was positive. I started treatment and ordered anti ccp level which turned out to be >200 iu highly positive. Inj methotrexate 15mg I'm weekly Prednisolone 30mg od, tab Nifedipine 20 mg bid eco spirine Vitamin E antioxidants omega 3 fatty acids iron vitD and B12 and one shot of Inj Methylprednisolone acetatae 2ml im pt improved like anything . After one month his popliteal dorsalis pedis pulse…
