Clinical aspects
The different clinical patterns of giant cell arteritis
H. De Boysson1, E. Liozon2, K.H. Ly3, A. Dumont4, C. Delmas5, A. Aouba6
- Department of Internal Medicine, Caen University Hospital; and University of Normandy, Caen, France. deboysson-h@chu-caen.fr
- Department of Internal Medicine and Clinical Immunology, Limoges University Hospital, Limoges, France.
- Department of Internal Medicine and Clinical Immunology, Limoges University Hospital, Limoges, France.
- Department of Internal Medicine, Caen University Hospital, Caen, France.
- Department of Internal Medicine, Caen University Hospital, Caen, France.
- Department of Internal Medicine, Caen University Hospital; and University of Normandy, Caen, France.
CER11656
2019 Vol.37, N°2 ,Suppl.117
PI 0057, PF 0060
Clinical aspects
Free to view
(click on article PDF icon to read the article)
PMID: 31162029 [PubMed]
Received: 23/08/2018
Accepted : 19/11/2018
In Press: 21/05/2019
Published: 21/05/2019
Abstract
OBJECTIVES:
To estimate the frequency of different clinical patterns in giant-cell arteritis (GCA) at onset.
METHODS:
All GCA patients consecutively followed-up in two referral centers for GCA with a biopsy-proven diagnosis and/or large-vessel vasculitis (LVV) demonstrated on imaging were analysed.
RESULTS:
We analysed the initial clinical presentation of 693 patients with a median age of 75 [48-94] years and including 486 (70%) women. We identified four different clinical patterns: isolated cranial GCA (in 80%), symptomatic LVV with or without associated cranial signs (9%), isolated fever or inflammatory response (9%), and isolated polymyalgia rheumatica with vasculitis (2%). A silent LVV was found in 110 (45%) out of the 247 patients without large-vessel symptoms who underwent imaging at GCA diagnosis. Symptomatic LVV patients were more frequently GC-dependent compared to other patterns (p=0.03) and showed the longest treatment duration (median: 37 [15–212] months versus <30 months for other clinical phenotypes; p=0.001).
CONCLUSIONS:
This study suggests that 80% of GCA patients display a typical presentation, whereas the other 20% showed rarer presentations. Patients with symptomatic LVV required longer treatment duration.
