Unmasking Takayasu Arteritis in a patient with steroid-induced Cushing syndrome

• Author Details:   
• Rengaraj Thirunanamoorthy
• Thaslim Ridhwana Barakath ^*
• Vignesh Vaithiyanathan
• Vilvarajeshwaran Balamurugan
• Dhinesh Vaithiyanathan

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Prolonged corticosteroid use causes Cushing syndrome to emerge with characteristic features like moon face, central obesity, buffalo hump, striae and hypertension. However, the use of corticosteroids also can mask underlying autoimmune conditions, delaying diagnosis. We describe the case of a 25-year-old women who initially presented with complaints of wide-spread body pain and obesity. Further examination ensured cushingoid features due to prolonged self-medication with tablet prednisolone of dose 5mg taken orally. On gradual steroid tapering, she developed limb claudication, unequal blood pressure and pulse discrepancies. Elevated inflammatory markers strengthened the suspicion of Takayasu arteritis, a large vessel arthritis. This case emphasizes the importance of evaluating potential underlying inflammatory diseases in individuals exhibiting exogenous cushingoid features, especially when unexplained vascular signs emerge. Unsupervised corticosteroid use not only increases the risk of adverse effects but may delay the diagnosis of serious conditions, emphasizing the need for cautious prescribing and public awareness.