Takayasu Arteritis in a 55-Year-Old Woman With Prior Mycobacterium leprae Infection: A Possible Postinfectious Association.

Takayasu arteritis (TAK) is a rare large-vessel vasculitis affecting the aorta and its major branches. Although autoimmune mechanisms are central, prior mycobacterial infections have been hypothesized to contribute to the disease onset. A 55-year-old South Asian woman with a history of vitiligo and treated multibacillary leprosy presented with right upper limb claudication and absent radial pulse. Angiography demonstrated thickening and narrowing of the right subclavian artery. Based on the 2022 ACR/EULAR classification criteria, TAK was diagnosed with a cumulative score of eight. Initial immunotherapy with intravenous prednisolone and methotrexate, followed by oral leflunomide, failed to achieve clinical improvement, following which endovascular stenting was planned. This case emphasizes the potential role of prior mycobacterial infections in TAK pathogenesis and highlights the need for early recognition, comprehensive vascular imaging, and individualized management in atypical or postinfectious presentations.