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Large vessel vasculitis without temporal artery involvement: Isolated form of giant cell arteritis?

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Lambert, Michel [UCL] Weber, A Boland, Benoît Deplaen, JF. Donckier, Julian [UCL]

Diffuse arterial involvement in giant cell arteritis (GCA) is well recognized. By contrast, GCA clinically isolated to large vessels without cephalic, rheumatologic or systemic symptoms represents a much rarer manifestation of the disease. We report the cases of 4 elderly women presenting with a diffuse and symptomatic occlusive disease without the typical signs of temporal arteritis, in whom biological, angiographic or pathological findings were suggestive of GCA. Medium to high dose oral corticosteroids were given to the 4 patients, in combination with various revascularization procedures, allowing a fair clinical response. Large vessel arteritis should be considered in elderly women with diffuse non-atherosclerotic occlusive disease and elevated erythrocyte sedimentation rate, even if typical features of GCA are lacking. In those cases, a long-term treatment with corticosteroids is mandatory, but surgical or angioplastic revascularization is often required.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 1996
Language Anglais
Journal information "Clinical Rheumatology" - Vol. 15, no. 2, p. 174-180 (1996)
Peer reviewed yes
Publisher Royal Belg Rheumatol Soc (Pellenberg)
issn 0770-3198
e-issn 1434-9949
Publication status Publié
Affiliation UCL - MD/MINT - Département de médecine interne
Keywords giant cell arteritis ; large vessel vasculitis ; temporal arteritis
Links
  1. Hamrin, B., Jonsson, N., Landberg, T. Involvement of large vessels in polymyalgia arteritica. Lancet 1965, 1, 1193–1196.
  2. HUNDER GENE G., Giant-cell Arteritis Producing an Aortic Arch Syndrome, 10.7326/0003-4819-66-3-578
  3. Thompson Joseph R., Simmons Charles R., Smith Louis L., Polymyalgia Arteritica with Bilateral Subclavian Artery Occlusive Disease : A Case Report, 10.1148/101.3.595
  4. Östberg, G. Morphological changes in the large arteries in polymyalgia arteritica. Acta Med Scand 1972, 533 (Suppl), 135–164.
  5. Pollock M., Blennerhassett J. B., Clarke A. M., Giant cell arteritis and the subclavian steal syndrome, 10.1212/wnl.23.6.653
  6. KLEIN ROBERT G., Large Artery Involvement in Giant Cell (Temporal) Arteritis, 10.7326/0003-4819-83-6-806
  7. Rivers, S.P., Baur, G.M., Inahara, T., Porter, J.M. Arm ischemia secondary to giant cell arteritis. Am J Surg 1982, 143, 554–558.
  8. Kyle, V., Hamilton Dutoit, S., Elias-Jones, J., Hazleman, B. Giant cell arteritis of myometrial and axillary arteries and polymyalgia rheumatica. Ann Rheum Dis 1987, 46, 256–258.
  9. de Gennes, C., Le Thi Huong, D., Wechsler, B., et al. Temporal arteritis revealed by upper limb gangrene. J Rheumatol 1989, 16, 130–132.
  10. Ninet, J.P., Bachet, Ph., Dumontet, C.M., Bureau du Colombier, P., Doublet Stewart, M., Pasquier, J.H. Subclavian and axillary involvement in temporal arteritis and polymyalgia rheumatica. Am J Med 1990,88, 13–20.
  11. Greene, G.M., Lain, D., Sherwin, R.M., Wilson, J.E., McManus, B.M. Giant cell arteritis of the legs. Clinical isolation of severe disease with gangrene and amputations. Am J Med 1986, 81, 727–733.
  12. Helfgott, S.M., Bauer, M.R. Pedal gangrene caused by giant cell arteritis. Arthritis Rheum 1987, 30, 1078–1079.
  13. Säve-Söderbergh, J., Malmvall, B.E., Andersson, R., Bengtsson, B.A. Giant cell arteritis as a cause of death. Report of nine cases. JAMA 1986, 255, 493–496.
  14. Perruquet, J.L., Davis, D.E., Harrington, T.M. Aortic arch arteritis in the elderly. An important manifestation of giant cell arteritis. Arch Intern Med 1986, 146, 289–291.
  15. Evans, J.M., Bowles, C.A., Bjornsson, J., Mullany, C.J., Hunder, G.G. Thoracic aortic aneurysm and rupture in giant cell arteritis. Arthritis Rheum 1994, 37, 1539–1547.
  16. Martin, J.F., Kittas, C., Triger, D.R. Giant cell arteritis of coronary arteries causing myocardial infarction. Br Heart J 1980, 43, 487–489.
  17. Lie, J.T., Failoni, D.D., Davis, Jr., D.C. Temporal arteritis with giant cell aortitis, coronary arteritis, and myocardial infarction. Arch Pathol Lab Med 1986, 110, 857–860.
  18. Hunder, G.G. Giant cell arteritis and polymyalgia rheumatica. In: Textbook of Rheumatology. Eds.: Kelley, W.N., Harris, E.D., Ruddy, S., Sledge, C.B., W.B. Saunders Company, 1993, 1103–1112.
  19. Bugg, E.J., Conrad, R.V., Grim, K.B. Giant cell arteritis. An acute hand syndrome. J Bone Joint Surg 1963, 45, 1269–1272.
  20. Di Giacomo, V., Fraioli, A., Carmenini, G., Schietroma, M., Meloni, F. Polymyalgia rheumatica and systemic giant cell arteritis. Bioptic findings of subclavian arteries in a case of aortic arc syndrome. Angiology 1984, 35, 528–533.
  21. Smith, J.A.E., O'Sullivan, M., Gough, J., Williams, B.D. Small intestinal perforation secondary to localized giant-cell arteritis of the mesenteric vessels. Br J Rheumatol 1988, 27, 236–238.
  22. LARSON T. S., Respiratory Tract Symptoms as a Clue to Giant Cell Arteritis, 10.7326/0003-4819-101-5-594
  23. Turiaf, J., Valère, P.E., Gubler, M.C. Pleurésie récidivante au cours de l'artérite temporale. Poumon Coeur 1967, 23, 633–637.
  24. Lie, J.T. When is arteritis of the temporal arteries not temporal arteritis? J Rheumatol 1994, 21, 186–189.
  25. Ashton-Key, M., Gallagher, P.J. Surgical pathology of cranial arteritis and polymyalgia rheumatica. In: Clinical Rheumatology, Giant cell arteritis. Eds.: Hazleman, B., Bengtsson, B.A., Baillière Tindall 1991, 387–404.
  26. Niet, J., Bachet, P., Bureau du Colombier, P. et al. Artérites sousclavières et axillaires au cours de la maladie de Horton et de la pseudopolyarthrite rhizomélique. Arch Mal Coeur 1988, 81, 89–97.
  27. Caselli R. J., Hunder G. G., Whisnant J. P., Neurologic disease in biopsy-proven giant cell (temporal) arteritis, 10.1212/wnl.38.3.352
  28. Collado, A., Santamaria, J., Ribalta, T., Cinta Cid, M., Canete, J.D., Tolosa, E. Giant-cell arteritis presenting with ipsilateral hemiplegia and lateral medullary syndrome. Eur Neurol 1989, 29, 266–268.
  29. Caselli R. J., Giant cell (temporal) arteritis: A treatable cause of multi-infarct dementia, 10.1212/wnl.40.5.753
Bibliographic reference Lambert, Michel ; Weber, A ; Boland, Benoît ; Deplaen, JF. ; Donckier, Julian. Large vessel vasculitis without temporal artery involvement: Isolated form of giant cell arteritis?. In: Clinical Rheumatology, Vol. 15, no. 2, p. 174-180 (1996)
Permanent URL http://hdl.handle.net/2078.1/47263