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Given his young age, limited vascular risk factors apart from hypertension and systemic vascular clues, further assessment revealed pretreatment CT angiographic evidence of large-vessel arteritis involving the abdominal aorta and branch vessels. Rheumatology favoured Takayasu arteritis after consideration of mimics. The stroke mechanism remained uncertain; hypertensive small-vessel disease was plausible although an inflammatory contribution was considered clinically possible. QuantiFERON-TB Gold was positive and was managed as latent tuberculosis after respiratory\/infectious diseases review found no evidence of active tuberculosis. Positron emission tomography (PET)-CT performed after immunosuppression showed thoracic nodal uptake, but subsequent high-resolution computed tomography (HRCT) thorax was unremarkable. Treatment included stroke therapy, corticosteroids, rifampicin and tocilizumab.<\/jats:p>","DOI":"10.1136\/bcr-2026-275101","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:20:47Z","timestamp":1785158447000},"page":"e275101","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Ischaemic stroke associated with Takayasu arteritis and latent tuberculosis: a diagnostic and therapeutic challenge"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3891-9569","authenticated-orcid":false,"given":"Muhammad Kazim","family":"Bashir","sequence":"first","affiliation":[{"name":"Geriatrics and Stroke Medicine, Letterkenny University Hospital, Letterkenny, Donegal, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Miranda","sequence":"additional","affiliation":[{"name":"Geriatrics and Stroke Medicine, Letterkenny University Hospital, Letterkenny, Donegal, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Won","family":"Yang","sequence":"additional","affiliation":[{"name":"Geriatrics and Stroke Medicine, Letterkenny University Hospital, Letterkenny, Donegal, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guadalupe","family":"Morote","sequence":"additional","affiliation":[{"name":"Rheumatology, Sligo University Hospital, Sligo, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026072706203473000_19.7.e275101.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2023-224543"},{"key":"2026072706203473000_19.7.e275101.2","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1002\/art.41774","article-title":"2021 American College of Rheumatology\/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis","volume":"73","author":"Maz","year":"2021","journal-title":"Arthritis Rheumatol"},{"key":"2026072706203473000_19.7.e275101.3","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-019-04818-5"},{"key":"2026072706203473000_19.7.e275101.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.11.045"},{"key":"2026072706203473000_19.7.e275101.5","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1007\/s00259-018-4021-4","article-title":"Three days of high-dose glucocorticoid treatment attenuates large-vessel 18F-FDG uptake in large-vessel giant cell arteritis but with a limited impact on diagnostic accuracy","volume":"45","author":"Nielsen","year":"2018","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2026072706203473000_19.7.e275101.6","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215672"},{"key":"2026072706203473000_19.7.e275101.7","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2022-223482"},{"key":"2026072706203473000_19.7.e275101.8","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70251-9"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-275101","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:20:48Z","timestamp":1785158448000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-275101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":8,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,27]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2026-275101"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-275101","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}