title: Giant cell arteritis presenting as limb claudication. Report and review of the literature.
abstract: Upper limb claudication and pulselessness is an uncommon presentation of giant cell arteritis (GCA), often resulting in delayed diagnosis. We describe such a case diagnosed by angiography, in which a temporal artery biopsy showed classic GCA, despite the absence of local signs or symptoms. A review of 26 similar cases revealed that in 81% of patients where the only manifestation of GCA was upper limb findings, temporal artery biopsy yielded positive findings. Steroid therapy clinically improved 24/26 patients. These findings suggest that a consideration of temporal artery biopsy early in the investigation will hasten diagnosis and appropriate therapy.
authors.affiliation: Wellesley Hospital, Department of Rheumatology, University of Toronto, ON, Canada.
authors.forename: B A
authors.initials: BA
authors.lastname: Walz-Leblanc
authors.forename: F M
authors.initials: FM
authors.lastname: Ameli
authors.forename: E C
authors.initials: EC
authors.lastname: Keystone
mesh_terms: D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis; D011859:Radiography; D013699:Temporal Arteries / Q000000981:diagnostic imaging / Q000473:pathology