Large-vessel giant cell arteritis

Abstract

Giant cell arteritis (GCA) is a primary systemic vasculitis. The disease predominantly affects the elderly population, more frequently women. A constant increase in GCA incidence during last decades has been reported. Chronic autoimmunological processes within the arterial wall in GCA leads to narrowing or even complete occlusion of artery lumen. Severe complications of GCA include end-organ ischemia, with frequently occurring visual loss and aortic aneurysm formation as a result of mural weakness. “Classic” GCA involves extracranial branches of the carotid arteries; most frequently the temporal artery. Giant cell arteritis isolated to large vessels without involvement of the cranial arteries represents a less common manifestation of the disease and may cause diagnostic difficulties. Early treatment with corticosteroids is the only safeguard chance to restrain and at least partially reverse serious effects of the disease. The clinician's awareness of both manifestations of GCA is crucial for early diagnosis and therapy.
Here we report the case of a 67-year-old woman with large-vessel GCA, affecting the aortic arch, the carotid and the subclavian arteries.