Angiographic findings in giant cell arteritis

Area of Science:

• Vascular Inflammation
• Rheumatology
• Ophthalmology

Background:

• Giant cell arteritis (GCA) is a systemic vasculitis affecting medium and large arteries.
• It commonly involves the cranial arteries and can lead to serious complications like vision loss.

Observation:

• A 65-year-old woman presented with intermittent blindness.
• Angiography revealed severe atherosclerotic changes and radiographic evidence of arteritis.
• A temporal artery biopsy confirmed giant cell arteritis.

Findings:

• Despite high-dose corticosteroid treatment, the patient experienced irreversible blindness.
• Elevated Westergren sedimentation rate (>40 mm/hr) in patients over 50 with relevant symptoms is highly suggestive of GCA.
• Angiography can aid in diagnosis and biopsy site selection.

Implications:

• Prompt diagnosis and aggressive treatment with high-dose prednisone are critical to prevent vision loss in GCA.
• This case highlights the potential for severe outcomes despite treatment, emphasizing the need for timely intervention.
• Multidisciplinary approaches involving rheumatology and ophthalmology are essential for managing GCA effectively.