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Simultaneous Pleural and Pericardial Effusion as First Clinical Manifestations of Giant Cell Arteritis: A Case Report

Vasiliki E Georgakopoulou1,2, Dimitrios Mermigkis2, Ourania Kairi3

  • 1Pulmonology Department, Laiko General Hospital, Athens, GRC.

Cureus
|October 5, 2020
PubMed

Insights

Giant cell arteritis (GCA), a vasculitis affecting older adults, can rarely present with simultaneous pleural and pericardial effusions. Early diagnosis via temporal artery biopsy is crucial, even without typical symptoms.

Area of Science:

  • Rheumatology
  • Internal Medicine
  • Vascular Biology

Background:

  • Giant cell arteritis (GCA) is a chronic granulomatous vasculitis primarily affecting cranial arteries in older individuals.
  • GCA is frequently associated with polymyalgia rheumatica (PMR).
  • Typical GCA symptoms include headache, jaw claudication, and vision changes, alongside PMR symptoms.

Observation:

  • This report details a rare case where simultaneous pleural and pericardial effusion were the initial clinical manifestations of GCA.
  • The patient presented with pleuropericardial effusion as the primary sign, without the more common GCA symptoms.

Findings:

  • Diagnosis was confirmed through a temporal artery biopsy, establishing GCA as the underlying cause of the effusions.
  • This case highlights the diverse and sometimes atypical presentations of GCA.

Implications:

  • Clinicians should consider GCA in elderly patients presenting with pleuropericardial effusions, even in the absence of classic GCA symptoms.
  • Prompt diagnosis and treatment of GCA are essential to prevent severe complications, including vision loss.

Keywords:
giant cell arteritispericardial effusionpleural effusiontemporal arteritis

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