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Clinical aspects

 

The different clinical patterns of giant cell arteritis


1, 2, 3, 4, 5, 6

 

  1. Department of Internal Medicine, Caen University Hospital; and University of Normandy, Caen, France. deboysson-h@chu-caen.fr
  2. Department of Internal Medicine and Clinical Immunology, Limoges University Hospital, Limoges, France.
  3. Department of Internal Medicine and Clinical Immunology, Limoges University Hospital, Limoges, France.
  4. Department of Internal Medicine, Caen University Hospital, Caen, France.
  5. Department of Internal Medicine, Caen University Hospital, Caen, France.
  6. 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

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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.

Rheumatology Article