Giant cell arteritis: Heterogeneity in clinical presentation and imaging results

ObjectiveGiant cell arteritis (GCA) is commonly known for its clinical presentation of temporal arteritis. However, GCA affects large arteries, predominantly the aorta and its proximal branches, in up to 75% of cases. We describe the clinical presentation and diagnostic test results of patients with large-vessel GCA.MethodsCase description of 11 patients with large-vessel GCA diagnosed consecutively in our hospital.ResultsThe clinical presentation of large-vessel GCA is highly variable, from systemic inflammation to aortic rupture. Imaging shows variable abnormalities, but 18-fluorodeoxyglucose positron-emission-tomography (18-FDG PET) seems to be a sensitive and reasonably specific diagnostic test for large-vessel GCA.ConclusionLarge-vessel GCA is a clinically heterogeneous condition. 18-FDG PET should be considered in the diagnostic work-up of suspected cases. Since this disorder has a high complication rate, and is responsive to treatment with corticosteroids, a high level of clinical suspicion is warranted.