Giant cell arteritis with CD8+ instead of CD4+ T lymphocytes as the predominant infiltrating cells in a young woman.
Giant cell arteritis is rarely reported in people aged less than 50 years. We report a case of giant cell arteritis in a woman who developed symptoms of dizziness, headache, bilateral sensorineural hearing impairment, and had 1 episode of transient left hemiparesis before the age of 30. Carotid angiography showed multiple segmental narrowing in cranial vessels. Subsequently, at the age of 31, she had weight loss and developed a fever. Chest radiograph revealed mediastinal widening, and chest computed tomography revealed dilated pulmonary arteries and veins. Coronary angiography and aortography showed irregular narrowing of the descending aorta and multiple stenosis, with aneurysmal dilatation involving the proximal and distal coronary, pulmonary and mesenteric arteries. Multinucleated giant cells and predominant CD8+ T lymphocyte infiltration were noted in a left temporal artery biopsy specimen. The patient's age and the finding of dilated pulmonary veins and prominent CD8+ T lymphocytes in the biopsy specimen suggest that this case was a distinct form of systemic giant cell arteritis.
Wu
Chien-Sheng
CS
Department of Internal Medicine, Far East Memorial Hospital, Taipei, Taiwan, ROC.
Hsu
Kwan-Lih
KL
Chang
Yih-Leong
YL
Lee
Kuang-Lun
KL
D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology; D006261:Headache / Q000209:etiology; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D011859:Radiography; D020521:Stroke / Q000209:etiology; D013699:Temporal Arteries / Q000473:pathology; D014012:Tinnitus / Q000209:etiology