Prognosis of large-vessel giant cell arteritis.
OBJECTIVE
The prognosis of large-vessel GCA (LV-GCA) has not yet been investigated. How does it compare to GCA without arm vasculitis (GCA controls)?


METHODS
Charts of 53 LV-GCA patients and 53 GCA controls were reviewed following a predetermined protocol. Telephone interviews of patients or their primary care physicians were conducted. Forty LV-GCA patients underwent follow-up duplex ultrasound examinations of proximal arm arteries.


RESULTS
The mean observation time was 50 (s.d. +/- 31) months. None of the LV-GCA patients developed ischaemic arm complications. In 30%, proximal arm artery wall swelling disappeared completely. It decreased in 53%. In 8% it remained unchanged, in 5% it increased and in 5% arteries occluded with collateral flow. After the start of treatment, anterior ischaemic optic neuropathy developed neither in LV-GCA patients nor in GCA controls, amaurosis fugax occurred in 4 and 6%, arterial hypertension in 53 and 66%, strokes in 9 and 9%, myocardial infarction in 2 and 2%, diabetes mellitus in 30 and 25%, osteoporosis in 38 and 23%, and osteoporotic fractures in 15 and 4%, respectively. Mean corticosteroid dose was 3.7 mg/day. Mean duration of therapy was 42 months. All differences were insignificant. Four LV-GCA patients developed vasculitic popliteal artery stenoses.


CONCLUSIONS
The prognosis of LV-GCA is benign with regard to ischaemic complications. Proximal artery wall swelling decreases in most cases. Its course is similar to GCA without proximal arm arteritis.
Schmidt
W A
WA
Medical Centre for Rheumatology Berlin-Buch, Karower Str. 11, 13125 Berlin, Germany. schmidt.wa@t-online.de
Moll
A
A
Seifert
A
A
Schicke
B
B
Gromnica-Ihle
E
E
Krause
A
A
D000368:Aged; D001132:Arm / Q000098:blood supply*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D013700:Giant Cell Arteritis / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D011379:Prognosis; D018615:Ultrasonography, Doppler, Color