[Atypical giant cell arteritis]

The atypical clinical course of giant-cell arteritis in the elderly (who may develop a clinical picture of severe consumptive disease) is illustrated by two observations with histologically confirmed temporal arteritis. In addition to fever and loss of weight, the inflammatory vascular process in a 78-year old female was reflected in arrhythmias (atrial fibrillation and atrial flutter), probably due to involvement of the coronary arteries, and occlusion of the left axillary artery. Similar general symptoms and various neurological deficits comprising amaurosis, mononeuritis multiplex, polyneuropathy, myopathy and finally subarachnoid hemorrhage characterized the disease in a 72-year-old man. The picture was further complicated by intestinal perforation. In both patients steroids brought considerable improvement and the disease process came to a standstill.