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Giant cell (temporal) arteritis diagnosed following upper limb claudication
L De Bruyne1, W Pauwels, F Raat
1Dienst Inwendige Ziekten-Gastro-enterologie Dienst Radiologie, AZ St.-Lucas Groenebriel 1, 9000 Gent, Belgium.
Insights
Giant cell arteritis, a condition affecting those over 50, can present without typical headaches. This case highlights diagnosis through limb claudication and biopsy, expanding understanding of the disease.
Area of Science:
- Rheumatology
- Vascular Medicine
- Internal Medicine
Background:
- Giant cell arteritis (GCA), also known as temporal arteritis, predominantly affects individuals over 50.
- Classic GCA symptoms include new-onset temporal headache, scalp tenderness, and jaw claudication, often co-occurring with polymyalgia rheumatica.
Observation:
- Uncommon GCA presentations involve systemic symptoms or large artery involvement.
- This report details a GCA case lacking typical temporal artery symptoms.
Findings:
- The patient presented with upper limb claudication, prompting further investigation.
- Angiography revealed large artery involvement, and a temporal artery biopsy confirmed the GCA diagnosis.
Implications:
- This case underscores the importance of considering GCA in older adults with atypical symptoms like limb claudication.
- Diagnosis can be achieved through angiography and biopsy even when classic signs are absent.
- Broadens the clinical recognition of giant cell arteritis presentations.
Abstract:
Giant cell arteritis or temporal arteritis occurs almost exclusively in people over 50 years of age. It classically presents with new onset temporal headache, scalp tenderness and jaw claudication. Proximal muscle pain and stiffness is often present because of frequent association with polymyalgia rheumatica. In most cases, the erythrocyte sedimentation rate is markedly elevated. Uncommon presentations include systemic symptoms and symptoms related to large artery involvement. We report a case of giant cell arteritis without symptoms related to the temporal artery, diagnosed angiographically following upper limb claudication and confirmed by temporal artery biopsy.