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Giant cell arteritis presenting with arm claudication.

J Kelly1, A G Rudd

  • 1Department of Elderly Care, St Thomas' Hospital, Lambeth Palace Road, Lambeth, London SE1 7EH, UK.

Age and Ageing
|June 8, 2001
PubMed
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Giant cell arteritis can cause aortic arch syndrome, leading to symptoms like arm weakness and falls. This case highlights the importance of considering this vascular complication even without typical symptoms.

Area of Science:

  • Vascular Medicine
  • Rheumatology
  • Internal Medicine

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting medium and large arteries.
  • Aortic arch syndrome, though less common, is a recognized complication of GCA.

Observation:

  • A 72-year-old woman presented with falls, malaise, lethargy, and arm weakness.
  • Physical examination revealed cold hands with absent radial pulses and diminished axillary systolic pressures.
  • Investigations showed elevated erythrocyte sedimentation rate and obliterative changes in subclavian and axillary arteries on aortogram.

Findings:

  • Temporal artery biopsy confirmed giant cell arteritis despite the absence of headache and normal-appearing temporal arteries.
  • The patient's symptoms, including falls, were attributed to arm claudication secondary to subclavian and axillary artery involvement.

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Implications:

  • Aortic arch syndrome can be the initial presentation of GCA, emphasizing the need for thorough vascular assessment.
  • Early diagnosis and treatment of GCA are crucial to prevent severe vascular complications and improve patient outcomes.
  • This case underscores the importance of considering GCA in elderly patients with unexplained limb ischemia or systemic symptoms.