Large vessel vasculitis without temporal artery involvement: isolated form of giant cell arteritis?
Diffuse arterial involvement in giant cell arteritis (GCA) is well recognized. By contrast, GCA clinically isolated to large vessels without cephalic, rheumatologic or systemic symptoms represents a much rarer manifestation of the disease. We report the cases of 4 elderly women presenting with a diffuse and symptomatic occlusive disease without the typical signs of temporal arteritis, in whom biological, angiographic or pathological findings were suggestive of GCA. Medium to high dose oral corticosteroids were given to the 4 patients, in combination with various revascularization procedures, allowing a fair clinical response. Large vessel arteritis should be considered in elderly women with diffuse non-atherosclerotic occlusive disease and elevated erythrocyte sedimentation rate, even if typical features of GCA are lacking. In those cases, a long-term treatment with corticosteroids is mandatory, but surgical or angioplastic revascularization is often required.
Lambert
M
M
Division of General Internal Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Weber
A
A
Boland
B
B
De Plaen
J F
JF
Donckier
J
J
D000368:Aged; D000792:Angiography; D015906:Angioplasty, Balloon, Coronary; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000628:therapy; D001366:Axillary Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D001706:Biopsy; D001799:Blood Sedimentation; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use*; D012078:Renal Artery Obstruction / Q000175:diagnosis; D013699:Temporal Arteries; D014657:Vasculitis / Q000175:diagnosis / Q000628:therapy
D000893:Anti-Inflammatory Agents; D011239:Prednisolone