Case report: giant cell arteritis in a patient with carotid atherosclerosis - a diagnostic dilemma

Area of Science:

• Vascular Medicine
• Rheumatology
• Neurology

Background:

• Carotid atherosclerosis and giant cell arteritis (GCA) present overlapping vascular symptoms like vision loss and stroke.
• Both conditions affect the carotid arteries, leading to arterial ischemia.
• Elderly patients (>55 years) with high vascular risk may have both atherosclerosis and GCA, complicating diagnosis.

Observation:

• Giant cell arteritis is a medical emergency requiring prompt treatment to prevent severe morbidity and mortality.
• Diffuse atherosclerosis can mask or mimic symptoms of GCA, creating a diagnostic pitfall.
• A case report highlights how atherosclerosis hindered the timely diagnosis of GCA.

Findings:

• Distinguishing between GCA and atherosclerosis is critical in elderly patients presenting with vascular events.
• Attributing all occlusive arterial disease solely to atherosclerosis in older individuals can delay GCA diagnosis.
• The presence of diffuse atherosclerosis complicated the diagnostic process for GCA in the reported case.

Implications:

• Physicians must consider GCA in elderly patients with vascular symptoms, even in the presence of atherosclerosis.
• Early GCA diagnosis and treatment are essential to prevent irreversible complications such as vision loss and stroke.
• This case underscores the importance of a comprehensive diagnostic approach to avoid misattributing vascular symptoms.