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Gender differences in giant cell arteritis: a case-control study.

Andreas Sturm1, Claudia Dechant2, Fabian Proft2

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Summary
This summary is machine-generated.

Giant cell arteritis (GCA) affects cranial arteries similarly in men and women. However, women, particularly those over 70, show significantly more extracranial axillary artery involvement and related symptoms.

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Area of Science:

  • Rheumatology
  • Vascular Medicine
  • Immunology

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium-sized arteries.
  • Understanding sex-based differences in GCA presentation is crucial for accurate diagnosis and management.
  • Previous studies have suggested potential variations in GCA's clinical spectrum between males and females.

Purpose of the Study:

  • To investigate sex-based disparities in the clinical manifestations and vascular patterns of giant cell arteritis.
  • To compare cranial and extracranial GCA involvement between female and male patient cohorts.
  • To identify age-related sex differences in GCA presentation.

Main Methods:

  • Retrospective analysis of 153 confirmed GCA cases (2002-2013).
  • Matched cohort design: two females for every male patient, matched for age.
  • Comparison of clinical symptoms, physical findings, lab values, and color duplex sonography results for temporal and axillary arteries.

Main Results:

  • No significant sex differences observed in cranial GCA.
  • Female patients demonstrated significantly higher rates of axillary artery involvement (48.9% vs. 27.5%, p=0.03).
  • This difference was pronounced in women aged ≥70, with higher axillary artery stenosis (27.3% vs. 0%), upper extremity ischemia (20.5% vs. 0%), and polymyalgia rheumatica (36.4% vs. 9.1%).

Conclusions:

  • Cranial artery involvement in GCA is consistent across sexes.
  • Female patients with GCA are more prone to extracranial arterial involvement, specifically of the axillary arteries.
  • Older women (≥70 years) with GCA exhibit a distinct pattern of extracranial disease.