[Polymyalgia rheumatica and giant cell arteritis, clinical and histopathological study of three cases]

We report three patients with giant cell arteritis but no clear clinical signs of temporal artery involvement, during an episode of polymyalgia rheumatica. In the first case a biopsy performed upon an apparently normal temporal artery showed a typical hortonian arteritis. The same finding was obtained from a pulseless right temporal artery in the second patient, who suffered a sudden blindness of right eye after a trigeminal neuralgia. In the third case the polymyalgic symptoms developed together with a syndrome of the aortic arc. The histologic findings of the temporal artery were normal, whereas the biopsy performed on both the subclavian arteries during surgical revascularization demonstrated a typical giant-cell arteritis in the acute stage. The cases mentioned above confirm that there is a close relation between polymyalgia rheumatica and Horton arteritis. In the latter the temporal localization could be inconstant.