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[Involvement of thoracic aorta revealing temporal arteritis. Three cases]
J-C Navellou1, H Gil, N Meaux-Ruault
1Service de médecine interne, CHU Jean-Minjoz, Besançon, France. jcnavellou@chu-besancon.fr
La Revue De Medecine Interne
|January 28, 2004
Summary
Temporal arteritis can affect the thoracic aorta, often discovered late via aneurysm or aortic insufficiency. Early diagnosis and long-term monitoring are crucial for managing this serious complication of Horton's disease.
Area of Science:
- Vascular Medicine
- Rheumatology
- Cardiology
Background:
- Temporal arteritis (Giant Cell Arteritis) can involve large vessels in 15% of cases.
- Diagnosis of large vessel involvement is often delayed, occurring years after initial diagnosis.
Observation:
- Three cases of temporal arteritis with thoracic aorta involvement are presented.
- Two patients presented with aortic aneurysms, one with aortic insufficiency, revealing the arteritis.
- Clinical signs of temporal arteritis were absent in two of the three patients.
Findings:
- Temporal artery biopsy was positive in two patients.
- Two patients received corticosteroid therapy, with one also on an immunosuppressive agent.
- All patients required surgical intervention.
Implications:
- Thoracic aorta involvement in Horton's disease is frequently diagnosed during corticosteroid tapering.
- Aneurysm rupture and aortic dissection are major complications of aortic affection in this condition.
- Patients with thoracic aorta involvement necessitate prolonged clinical and radiological surveillance.