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Related Experiment Videos

Fatal vertebral giant cell arteritis

M M Sheehan1, C Keohane, C Twomey

  • 1Department of Pathology, Cork Regional Hospital, Wilton, Ireland.

Journal of Clinical Pathology
|December 1, 1993
PubMed
Summary

Giant cell arteritis (GCA) rarely causes death, typically from coronary or vertebral artery issues. This case details a fatal GCA presentation with normal inflammatory markers, involving vertebral artery dissection.

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Area of Science:

  • Vascular Pathology
  • Rheumatology
  • Neuropathology

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium arteries.
  • While GCA can lead to severe complications, death is uncommon and often linked to acute coronary or vertebral artery involvement.
  • Temporal arteritis is the most common clinical manifestation of GCA.

Observation:

  • A fatal case of GCA occurred in a woman previously treated for temporal arteritis for eight months.
  • The patient presented with a normal erythrocyte sedimentation rate (ESR), a common inflammatory marker for GCA.
  • Post-mortem examination revealed critical vascular pathology.

Findings:

  • The autopsy identified dissection and thrombosis of the intracranial portion of the left vertebral artery, directly attributed to GCA.
  • Focal GCA involvement of the coronary arteries was also observed.
  • This represents the first reported case of vertebral artery dissection caused by GCA.

Implications:

  • This case highlights that GCA can present atypically, even with normal inflammatory markers.
  • Vertebral artery dissection is a rare but potentially fatal complication of GCA.
  • The findings underscore the importance of considering GCA in the differential diagnosis of arterial dissections, irrespective of ESR levels.

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