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Pleural effusion revealing giant cell arteritis
Isabelle Marie1, Philippe Heliot, Jean-François Muir
1Department of Internal Medicine, Centre Hospitalier Universitaire de Rouen-Boisguillaume, F-76031 Rouen Cedex, France.
European Journal of Internal Medicine
|June 3, 2004
Summary
Giant cell arteritis (GCA) rarely affects the lungs, but can present unusually. This case highlights pleural effusion as an initial GCA manifestation in elderly patients.
Area of Science:
- Rheumatology
- Pulmonology
- Internal Medicine
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium arteries.
- Pulmonary involvement in GCA is uncommon and typically manifests later in the disease course.
- Unusual presentations of GCA can delay diagnosis and treatment.
Purpose of the Study:
- To report a rare case of GCA presenting with isolated pleural effusion.
- To emphasize the importance of considering GCA in elderly patients with unexplained pulmonary symptoms.
- To highlight the diagnostic challenges posed by atypical GCA manifestations.
Main Methods:
- Case report of a patient with left pleural effusion.
- Diagnostic workup including thoracic CT scan.
- Treatment with steroid therapy and monitoring of clinical response.
Main Results:
- Thoracic CT revealed significant left pleural effusion and aortic wall thickening.
- The patient showed rapid clinical improvement and complete resolution of pleural effusion with steroid treatment.
- Absence of typical GCA symptoms like headache or jaw claudication.
Conclusions:
- Pleural effusion can be an initial presenting sign of GCA.
- GCA should be considered in the differential diagnosis of pulmonary manifestations in the elderly, even without classic symptoms.
- Early diagnosis and treatment with corticosteroids are crucial for favorable outcomes in GCA.