[Limb arteritis in Horton disease: five cases].
BACKGROUND
Giant cell arteritis of the limbs is rarely reported. It may be underestimated because it is usually asymptomatic. The aim of this study was to describe the distinctive features of this involvement.


METHODS
Retrospective study of 50 patients with giant cell arteritis diagnosed from January 1985 to December 2007, satisfying the American college of rheumatology (ACR) classification criteria. All five patients had typical lesion at examination of temporal artery biopsy. Among these patients, those with ischemic manifestations of the limbs were selected. All patients disclosed elevated acute phase reactants and typical radiological findings. Temporal artery histopathology was made necessary to select patients.


RESULTS
Five female (mean age: 66.8 years) out of 50 patients (10%) with temporal arteritis presented with symptomatic limb arteriopathy. Limb arteritis was the presenting feature in four patients. Clinical presentation was similar to other non-inflammatory arteritis. One patient presented with involvement of her four limbs. Typical arteriographic abnormalities were presents in all patients (occlusion or moniliform stenosis without atheromatous lesions). Despite therapy with corticosteroids associated to anticoagulants or antiplatelet drugs, four amputations were necessary.


CONCLUSIONS
Specific limb involvement may be the presenting feature of temporal arteritis. It can mimic arteriosclerosis vascular disease, particularly prevalent in this age group.
Benjilali
L
L
Service de médecine interne, hôpital Ibn Sina, Rabat, Maroc.
Tazi Mezalek
Z
Z
Raffali
J
J
El Imadi
H
H
Harmouche
H
H
Adnaoui
M
M
Bensaid
Y
Y
Aouni
M
M
Maaouni
A
A
D000368:Aged; D000671:Amputation, Surgical; D000925:Anticoagulants / Q000627:therapeutic use; D001167:Arteritis / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D001706:Biopsy; D004359:Drug Therapy, Combination; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D013700:Giant Cell Arteritis / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007866:Leg / Q000473:pathology; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011150:Popliteal Artery / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D016896:Treatment Outcome
D000925:Anticoagulants; D005938:Glucocorticoids; D010975:Platelet Aggregation Inhibitors