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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

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Head and neck giant cell arteritis: an autoimmune disease with many faces

Markus Wirth1, Lucas Schirmer2, Benedikt Hofauer1

  • 1a Department of Otolaryngology - Head and Neck Surgery , Klinikum rechts der Isar, Technical University of Munich , Munich , Germany.

Acta Oto-Laryngologica
|April 26, 2017
PubMed

Insights

Giant cell arteritis (GCA) can present atypically in the head and neck, particularly with odynophagia and elevated CRP. Consider GCA in elderly patients with these symptoms to avoid diagnostic delays.

Area of Science:

  • Otolaryngology
  • Rheumatology
  • Internal Medicine

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium-sized arteries.
  • Head and neck manifestations of GCA can be diverse, sometimes presenting atypically.

Purpose of the Study:

  • To characterize the clinical presentation of head and neck GCA.
  • To develop a diagnostic pathway for atypical GCA cases presenting to an ENT department.

Main Methods:

  • Retrospective analysis of 65 patients diagnosed with head and neck GCA between 2002 and 2012.
  • Focus on manifestations encountered in the otolaryngology, ophthalmology, and neurology departments.

Main Results:

  • Vision loss (83%) and new-onset headache (63%) were the most common symptoms.
  • Eight patients (12%) had infrequent presentations, with odynophagia and elevated CRP being the most common atypical sign, often mistaken for infection.
  • A diagnostic pathway was formulated using ACR criteria and clinical findings.

Conclusions:

  • Infrequent presentations of GCA are common in ENT departments.
  • Odynophagia with elevated CRP in older patients warrants consideration for GCA, even without typical findings.
  • Anticipating GCA as a differential diagnosis in such cases is crucial for timely management.
Abstract

Keywords:
Giant cell arteritisamaurosisatypical manifestationdiagnostic pathwayhead and neck

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