A Girl with Hypertension

She had hypokalemia, metabolic alkalosis, an elevated blood level of C-reactive protein, and an elevated erythrocyte sedimentation rate. Examination revealed a left carotid bruit. During hospitalization, she developed blurry vision and encephalopathy secondary to hypertensive emergency. The overall picture led the pediatricians to suspect a large-vessel vasculitis — of which Takayasu arteritis would be the most common in an adolescent girl — and the diagnosis was confirmed on contrast-enhanced magnetic resonance and CT angiography (Figure 1).