[Giant cell arteritis-related upper/lower limb vasculitis].
Upper/lower limb vasculitis has been considered an uncommon manifestation of giant cell arteritis, occurring in 3 to 16% of patients. Upper/lower limb vasculitis is still associated with significant morbidity, leading to limb/toe amputation in 5.6 to 15.8% of patients. Yearly clinical vascular examination should be performed systematically to screen upper/lower limb vasculitis at an early stage in patients with giant cell arteritis. Duplex ultrasound has proved to be a reliable non-invasive imaging method for detecting arterial stenoses of the upper/lower limbs in patients with giant cell arteritis. Patients with giant cell arteritis-related upper/lower limb vasculitis should undergo routine investigations to detect underlying aortic complications, concomitant aortic localizations being encountered in more than 50% of cases. Prednisone is the first-line therapy at an initial dose of 0.7-1 mg/kg daily. Prevention of platelet aggregation with low-dose aspirin is potentially effective in preventing ischemic complications of GCA. The indication of surgical therapy should be based on the severity of giant cell arteritis-related upper/lower limb clinical symptoms to avoid unnecessary morbidity in the course of interventional therapy.
CHU de Rouen, Département de médecine interne, 76301 Rouen cedex, France.
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D001132:Arm / Q000098:blood supply*; D013700:Giant Cell Arteritis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007866:Leg / Q000098:blood supply*; D014657:Vasculitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy