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Bilateral parotitis revealing giant cell arteritis: A case report
Robin Arcani1, Tatiana Horowitz2, Pierre-André Jarrot3
1Internal Medicine and Therapeutics Department, CHU de la Timone, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Inra 1260, Inserm UMR_S 1263, Center for Cardiovascular and Nutrition Research (C2VN), Aix-Marseille University, Marseille, France.
Joint Bone Spine
|February 15, 2025
Summary
Giant cell arteritis (GCA) can present atypically with parotitis as the main symptom in elderly patients. Early consideration of GCA is crucial for prompt diagnosis and treatment, even without classic GCA signs.
Area of Science:
- Rheumatology
- Internal Medicine
- Vascular Inflammation
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium-sized arteries.
- Typical GCA symptoms include headache, jaw claudication, and visual disturbances, but presentations can be atypical.
Purpose of the Study:
- To report an unusual case of GCA presenting primarily with parotitis.
- To emphasize the importance of considering GCA in elderly patients with unexplained parotitis and inflammation.
Main Methods:
- Case report of an 88-year-old woman with parotitis as the chief complaint.
- Diagnostic workup included laboratory tests, Doppler ultrasound of temporal arteries, PET/CT scan, and temporal artery biopsy.
- Treatment involved prednisone therapy.
Main Results:
- The patient presented with painful bilateral parotid enlargement and mild headaches, lacking classic GCA symptoms.
- Inflammatory markers were elevated, and imaging confirmed arterial inflammation, including vessels supplying the parotid glands.
- Temporal artery biopsy confirmed the diagnosis of GCA, and prednisone treatment led to rapid symptom and marker improvement.
Conclusions:
- Parotitis can be a rare, primary presenting symptom of Giant Cell Arteritis.
- GCA should be suspected in elderly individuals with persistent, unexplained parotitis and systemic inflammation.
- Prompt diagnosis and treatment of GCA are essential to prevent complications.
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