RT Journal Article
SR Electronic
T1 Lower limb giant cell arteritis and temporal arteritis: followup of 8 cases.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1407
OP 1412
VO 28
IS 6
A1 C Le Hello
A1 H Lévesque
A1 M Jeanton
A1 N Cailleux
A1 F Galateau
A1 C Peillon
A1 P Veyssier
A1 J Watelet
A1 P Letellier
A1 H Courtois
A1 D Maïza
YR 2001
UL http://www.jrheum.org/content/28/6/1407.abstract
AB Among 8 patients with giant cell arteritis (GCA) (6 women, 2 men) whose clinical presentations were compatible with temporal arteritis (TA), 6 were followed for 37-105 (mean 74.9) months, one died shortly after treatment onset, and the last was asymptomatic (10 mg steroids/day) when lost to followup at 29 months. All 8 patients had bilateral leg claudication of recent onset; for 6 patients, this was the first symptom. All leg angiograms showed multiple, bilateral, long and smooth stenoses, thromboses, or both. Biopsies of diseased leg arteries from 4 patients provided histological proof of GCA; another case was histologically proven post mortem. Among the 5 patients who met at least 3 American College of Rheumatology criteria of GCA or TA, 3 without histologically documented leg GCA also had biopsy proven temporal GCA (n = 1), or headaches and claudication and angiographic inflammatory arteritis of the arms (n = 2). All patients received steroids; 3 had bypasses, one with endarterectomy. Five are asymptomatic after 24-100 months of steroids (mean 50.6). Revascularization was not successful; one amputation was necessary. Large artery involvement in GCA can affect the legs. Bilateral and rapidly progressive intermittent claudication of recent onset is the most common symptom, even in the absence of headaches or the presence of a silent inflammatory syndrome. Early diagnosis allows rapid initiation of steroid therapy, which is usually able to generate a sufficiently good response to avoid vascular surgery.