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A 20-year-old woman with no comorbid illness was admitted with a history of recurrent episodes of giddiness over the past 6 months. On clinical examination her peripheral pulses were absent and blood pressure was not recordable in both upper limbs. Laboratory investigations showed an elevated erythrocyte sedimentation rate (ESR) and thrombocytopenia. Liver and renal function tests were normal. …
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.