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Sex differences in giant cell arteritis
Ran Nir-Paz1, Anat Gross, Tova Chajek-Shaul
1Department of Medicine, Hadassah University Hospital, Jerusalem, Israel.
Insights
Men and women present differently with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR). Male patients show higher rates of severe eye involvement, suggesting a need for more aggressive treatment.
Area of Science:
- Rheumatology
- Internal Medicine
- Epidemiology
Background:
- Sex differences in the presentation of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) have been suggested but not definitively proven.
- Understanding these differences is crucial for accurate diagnosis and effective treatment strategies.
Purpose of the Study:
- To compare the medical history, symptoms, and clinical signs between male and female patients diagnosed with GCA or PMR.
- To identify potential sex-based variations in disease presentation and comorbidities.
Main Methods:
- A retrospective study was conducted at Hadassah University Hospitals in Jerusalem, Israel.
- Medical data from 88 patients (59 women, 29 men) diagnosed with GCA or PMR between 1980 and 1998 were evaluated.
Main Results:
- Men had higher prevalence of non-insulin dependent diabetes mellitus, cerebrovascular accidents, and chronic renal failure.
- Women showed a trend towards higher prevalence of hypertension.
- Male patients exhibited more frequent eye involvement, including a tendency towards blindness, while female patients were more likely to have jaw involvement and polymyalgia symptoms.
Conclusions:
- Significant sex differences exist in the history, clinical presentation, and laboratory findings of GCA and PMR patients.
- The higher prevalence of severe eye complications in men warrants a more aggressive treatment approach for male patients.
Objective:
Although it has been suggested that sex differences underlie the varying presentation of giant cell arteritis (GCA), this has not been proven. We compared medical history, symptoms, and signs in patients with GCA and polymyalgia rheumatica (PMR).
Methods:
We performed a retrospective study in the Hadassah University Hospitals in Jerusalem, Israel. We evaluated medical data of 88 patients (59 women, 29 men) admitted with the diagnosis of GCA or PMR between 1980 and 1998.
Results:
Comparison of comorbidities among patients showed that non-insulin dependent diabetes mellitus, cerebrovascular accidents, and chronic renal failure are more prevalent in men, while hypertension has a trend to be more prevalent in women. In the clinical presentation of the disease, eye involvement is more prevalent in men, with a tendency towards blindness. Women tend to have higher prevalence of jaw involvement and complaints of polymyalgia. The sexes also seem to differ with respect to laboratory presentation of the disease.
Conclusion:
Men and women with GCA and PMR differ in their history, presentation, and laboratory findings. Our results recommend a more aggressive approach to male patients in view of the higher prevalence of severe eye involvement and blindness.