[Large vessel vasculitis without aortitis in giant cell arteritis: About 4 cases].
Jeremy Antoniadis1, Audrey Benyamine1, Estelle Jean2
1Service de médecine interne, hôpital Nord, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France.
La Revue De Medecine Interne
|February 5, 2026
Summary
Giant cell arteritis (GCA) with large vessel vasculitis (LVV) rarely affects vessels beyond the aorta. This study highlights four cases of LVV-GCA without aortitis, emphasizing the need for further research.
Area of Science:
- Rheumatology
- Vascular Medicine
- Immunology
Background:
- Giant cell arteritis (GCA) is the most common vasculitis in individuals over 50.
- Large vessel vasculitis (LVV) occurs in 40-70% of GCA cases, typically involving the aorta.
- Extracranial LVV in GCA is infrequently documented.
Purpose of the Study:
- To describe cases of LVV-GCA presenting without aortitis.
- To characterize the clinical presentation and diagnostic findings in this rare GCA phenotype.
- To discuss the implications for patient management and prognosis.
Main Methods:
- Case series of four patients with LVV-GCA.
- Diagnostic tools included PET-CT, CT angiography, temporal artery biopsy, and ophthalmological examination.
- Clinical data on disease progression and treatment response were collected.
Main Results:
- Four cases of LVV-GCA without aortitis were identified.
- Vessel involvement included limb arteries (3 cases) and mesenteric artery (1 case).
- Three patients demonstrated corticosteroid dependence; one patient was lost to follow-up.
Conclusions:
- LVV-GCA without aortitis is a rare but distinct clinical entity.
- Corticosteroid dependence was observed in a majority of the reported cases.
- Further large-scale studies are required to establish the prognosis and optimal therapeutic strategies for this GCA variant.
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