title: Giant cell arteritis: clinical features of patients visiting a headache clinic in Japan.
abstract: OBJECTIVE
  The first symptom of giant cell arteritis (GCA) is usually a headache. Japan has a low prevalence of GCA, and clinical features of this disorder have not been fully investigated. We conducted a retrospective evaluation of clinical features in patients with giant cell arteritis who visited a headache clinic in Japan.
  
  
  METHODS
  Clinical and demographic data were obtained from clinical examinations, face-to-face interviews, and hospital records.
  
  
  METHODS
  Subjects comprised 19 patients (9 men, 10 women).
  
  
  RESULTS
  Mean age at disease onset was 78.1 ± 4.8 years (range, 71-86 years). Seventeen of 19 patients (89.5%) had consulted other medical institutions before consulting our hospital, but only 2 of those patients had been diagnosed with GCA at these medical institutions. Manifestations at disease onset included headache (89.5%), ear pain (5.3%), and jaw pain (5.3%). Ocular manifestations were reported in 2 patients (10.5%). No loss of vision occurred. One patient showed trigeminal nerve palsy involving the third division of the nerve. Jaw claudication was observed in 3 patients (15.8%). Concomitant polymyalgia rheumatica was seen in 3 patients (15.8%). No patient showed upper respiratory tract symptoms, arm claudication, or aortic aneurysms.
  
  
  CONCLUSIONS
  Although most patients had consulted other medical institutions before consulting our hospital, they were not diagnosed with GCA at these institutions. Infrequent clinical findings of GCA and lack of symptoms other than headache may contribute to the high rate of unrecognized and misdiagnosed cases of GCA.
authors.affiliation: Department of Neurology, Japanese Red Cross Shizuoka Hospital, Japan. neurologyimai@gmail.com
authors.forename: Noboru
authors.initials: N
authors.lastname: Imai
authors.forename: Ryou
authors.initials: R
authors.lastname: Kuroda
authors.forename: Takashi
authors.initials: T
authors.lastname: Konishi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Serizawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kobari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000208:ethnology* / Q000628:therapy; D006261:Headache / Q000175:diagnosis* / Q000208:ethnology* / Q000628:therapy; D006801:Humans; D007564:Japan / Q000208:ethnology; D008297:Male; D010044:Outpatient Clinics, Hospital; D012189:Retrospective Studies