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

Fanny Duval1, Idoia Lacoste1, Gaël Galli1

  • 1Department of Neurology, Nerve-Muscle Unit.

The Neurologist
|December 22, 2017
PubMed

Insights

Giant cell arteritis (GCA) can cause rare neurological issues like brachial radiculoplexopathy in older adults. Early recognition of GCA symptoms is crucial to prevent disability from this treatable condition.

Area of Science:

  • Neurology
  • Rheumatology
  • Vascular Medicine

Background:

  • Giant cell arteritis (GCA) is a large-vessel vasculitis commonly affecting the temporal arteries in older individuals.
  • Neurological complications, both central and peripheral, are recognized manifestations of GCA.
  • Classic GCA symptoms include headache, scalp tenderness, and elevated inflammatory markers.

Purpose of the Study:

  • To highlight brachial radiculoplexopathy as a rare neurological complication of GCA.
  • To emphasize the importance of considering GCA in older patients presenting with unexplained brachial radiculoplexopathy.
  • To reduce diagnostic delays and prevent disability associated with GCA.

Main Methods:

  • Case report of an 85-year-old woman with bilateral acute brachial radiculoplexopathy and GCA.
  • Review and comparison of the presented case with 16 similar cases from medical literature.
  • Clinical assessment including neurological examination and inflammatory marker evaluation.

Main Results:

  • The patient presented with bilateral acute brachial radiculoplexopathy and oculomotor palsy, despite lacking typical cranial GCA symptoms.
  • The case illustrates that GCA can manifest with atypical neurological presentations, including peripheral nerve involvement.
  • Comparison with literature cases supports brachial radiculoplexopathy as a rare but significant neurological complication of GCA.

Conclusions:

  • Brachial radiculoplexopathy, particularly affecting C5-C6 nerve roots, warrants investigation for GCA in patients over 50 with elevated inflammatory markers.
  • Prompt diagnosis of GCA is essential to initiate treatment and mitigate the risk of severe neurological disability.
  • Expanding the recognition of GCA's neurological spectrum can improve patient outcomes.
Abstract

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