[Various forms of giant cell arteritis: diagnostic difficulties and significance of biopsies]

15 cases of giant cell arteritis newly diagnosed in the period 1979-1982 at the University Medical Outpatient Clinic, Basle, are presented. 10 cases can be classified as polymyalgia rheumatica, including one patient with aortic arch syndrome and involvement of the femoral arteries. 4 patients had cranial involvement. One patient diagnosed at an early stage exhibited non-characteristic general symptoms only. In 3 patients the diagnosis was suspected immediately, while the others underwent extensive investigations to rule out malignant and infectious diseases. Localized or generalized osteoarthrosis was often present. Most of the patients had severe general symptoms. Elevated sedimentation rate (88 +/- 34 mm 1st hr), anemia (11.6 +/- 1.8 g/dl) and elevation of alpha 2-globulin fraction were constant laboratory findings. Histologic examination of the temporal artery was positive in 2 of 7 cases with polymyalgia rheumatica. Out of 4 cases with cranial symptoms 3 had a positive histologic result. The biopsy result can be improved by removal of a more generous sample of artery segment. Therapy, relapses and complications are discussed.