Giant cell arteritis: Diagnostic approach based on a retrospective study on 21 cases

Area of Science:

• Rheumatology
• Internal Medicine
• Ophthalmology

Background:

• Giant cell arteritis (GCA) is a systemic vasculitis affecting large and medium arteries.
• Early diagnosis and treatment are vital to prevent severe complications such as vision loss and stroke.

Purpose of the Study:

• To outline the diagnostic and therapeutic challenges in managing giant cell arteritis (GCA).
• To highlight the importance of timely intervention in GCA cases.

Main Methods:

• Retrospective study of 21 GCA patients diagnosed using 1990 ACR criteria.
• Data collected over a 5-year period (2014-2019) at Mohamed Tahar Maamouri Hospital, Tunisia.
• Review of clinical presentation, diagnostic workup (biopsy, imaging), treatment, and outcomes.

Main Results:

• Headache and ocular manifestations were the most common presenting symptoms.
• Temporal artery biopsy confirmed diagnosis in 9 cases; imaging revealed aortitis/ectasia in 2 cases.
• Corticosteroids were primary treatment; adverse effects included osteoporosis and diabetes. Two patients experienced irreversible blindness due to delayed consultation.

Conclusions:

• Giant cell arteritis (GCA) requires prompt management due to risks of sight loss and stroke.
• Despite rarity in Tunisia, GCA is a medical emergency demanding swift diagnosis and treatment.
• Adherence to diagnostic criteria and prompt initiation of therapy are essential for favorable outcomes.