Respiratory and otolaryngologic manifestations of giant cell arteritis

The classical presentation of giant cell arteritis (GCA) includes the new onset of headache, scalp tenderness, facial pain or jaw claudication in an older patient. Many patients with GCA have features consistent with the diagnosis of polymyalgia rheumatic (PMR) and nearly all have elevated markers of inflammation such as the erythrocyte sedimentation rate (ESR) or the serum C-reactive protein (CRP). Respiratory and ear-nose-throat (ENT) signs and symptoms such as cough, tongue infarction, trismus, hearing loss and facial swelling are less commonly described, yet they may be the initial presentation of GCA. Our aim was to review the published literature on the topic of respiratory and otologic manifestations of GCA.

A literature search was performed on PUBMED and MEDLINE using the following keywords: GCA, temporal arteritis, pulmonary, respiratory, ENT, cough, tongue necrosis.

The upper and lower airways manifestations of GCA include a wide variety of conditions that could be caused by ischaemia due to the vasculitis.

It is important to recognize these atypical presentations because they may be the sole initial manifestation of the disease. Early suspicion and confirmation of the diagnosis of GCA can help to prevent more catastrophic consequences of unrecognized disease, including stroke and blindness.