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Concurrent temporal arteritis and Churg-Strauss syndrome
E Vidal1, F Liozon, A M Rogues
1Department of Internal Medicine, University of Limoges, France.
Insights
Churg-Strauss syndrome can affect temporal arteries, presenting as panarteritis. This highlights that temporal artery inflammation is not always giant cell arteritis, broadening differential diagnoses for vasculitis.
Area of Science:
- Rheumatology
- Pathology
- Vascular Medicine
Background:
- Giant cell arteritis (GCA) and polyarteritis nodosa (PAN) are systemic vasculitides.
- Temporal artery involvement is characteristic of GCA.
- Churg-Strauss syndrome (CSS) is a rare systemic vasculitis.
Observation:
- A 41-year-old man presented with temporal artery lesions and Churg-Strauss syndrome.
- Histopathology revealed panarteritis without giant cells or fibrinoid necrosis.
- This case presents a rare instance of CSS with temporal artery involvement.
Findings:
- CSS can manifest with temporal artery inflammation, mimicking GCA.
- The study reviews overlapping features between PAN, GCA, and CSS.
- Classification of overlapping vasculitides into PAN with unusual temporal artery localization and GCA with disseminated arterial injuries is proposed.
Implications:
- Temporal artery biopsies should be interpreted cautiously in suspected vasculitis.
- Consider CSS in the differential diagnosis of arteritis involving the temporal arteries.
- This case expands the understanding of CSS manifestations and vasculitis classification.
Abstract:
We describe the case of a 41-year-old man who presented with clinical and histopathologic evidence of temporal artery lesions associated with the Churg-Strauss syndrome. Pathological examination of the temporal artery showed panarteritis without giant cell formation or fibrinoid necrosis. We review the world literature concerning the vasculitides with features that overlap giant cell arteritis (GCA) and polyarteritis nodosa (PAN) and classify into 2 sub-groups PAN with unusual temporal artery localization and GCA with variably disseminated arterial injuries. These cases emphasize the fact that not all arteritis involving the temporal arteries is GCA. Only 3 cases with temporal artery involvement and concurrent Churg-Strauss syndrome have been published.