Disseminated giant cell arteritis

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E Grishman1

  • 1Department of Pathology, Mount Sinai School of Medicine, City Hospital Center at Elmhurst, New York, New York.

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
|September 1, 1993
PubMed

Insights

Giant cell arteritis and polymyalgia rheumatica can affect various blood vessels. This case highlights unusual widespread arterial involvement, including coronary arteries, leading to a fatal myocardial infarction.

Area of Science:

  • Rheumatology
  • Pathology
  • Cardiovascular Medicine

Background:

  • Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are common vasculitides in the elderly.
  • GCA typically affects cranial arteries, while PMR involves proximal muscles.

Observation:

  • A 76-year-old woman presented with features of both GCA and PMR.
  • Autopsy revealed extensive arteritis involving cranial, large elastic, and small muscular arteries, including vasa vasorum.

Findings:

  • Histological examination confirmed simultaneous involvement of temporal arteries (biopsy) and widespread systemic arteries (autopsy).
  • Coronary arteritis was identified as the cause of fatal myocardial infarction.

Implications:

  • This case underscores the potential for extensive and simultaneous arterial system involvement in GCA/PMR.
  • It emphasizes the critical need for early diagnosis and comprehensive management to prevent severe cardiovascular complications like myocardial infarction.

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