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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
06:35

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

Published on: February 8, 2019

Giant cell arteritis: a clinical and pathological study

Mahesha Vankalakunti1, B G Dharmanand, Suresh Chandra

  • 1Columbia Asia Referral Hospital, Malleswaram, Bangalore 560055, Karnataka, India.

The National Medical Journal of India
|September 16, 2010
PubMed

Insights

Giant cell arteritis, a large vessel vasculitis, appears under-recognized in India. Pyrexia of unknown origin is a common symptom in Indian patients with this condition.

Area of Science:

  • Rheumatology
  • Internal Medicine
  • Vascular Inflammation

Background:

  • Giant cell arteritis (GCA) is a vasculitis affecting large and medium-sized vessels, prevalent in Western populations.
  • Limited reports exist on GCA among Indian patients, suggesting potential under-recognition.
  • This study focuses on the clinical presentation and diagnosis of GCA in an Indian cohort.

Purpose of the Study:

  • To investigate the characteristics of giant cell arteritis in Indian patients.
  • To highlight the diagnostic challenges and common presentations of GCA in this population.
  • To emphasize the importance of considering GCA in the differential diagnosis of pyrexia of unknown origin in elderly Indians.

Main Methods:

  • Retrospective analysis of 9 Indian patients (5 men, 4 women; age 59-81 years) undergoing temporal artery biopsy.
  • Evaluation of clinical features, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, and biopsy results.
  • Assessment of treatment response to steroids.

Main Results:

  • Eight out of nine patients had biopsy-proven giant cell arteritis.
  • Common presenting symptoms included pyrexia of unknown origin (4/9), headache (6/9), and blurred vision (2/9).
  • Elevated ESR (mean 96 mm/hr) and CRP levels were observed; temporal artery biopsies showed characteristic inflammatory infiltrates with giant cells in most cases. All patients responded well to steroid therapy.

Conclusions:

  • Giant cell arteritis may be under-diagnosed in India.
  • Pyrexia of unknown origin is a significant presenting feature of GCA in Indian patients.
  • GCA should be considered in the differential diagnosis of elderly patients presenting with unexplained fever.
Abstract

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