1. The different clinical patterns of giant cell arteritis.
- Author
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de Boysson H, Liozon E, Ly KH, Dumont A, Delmas C, and Aouba A
- Subjects
- Aged, Aged, 80 and over, Biopsy, Female, Humans, Male, Middle Aged, Phenotype, Giant Cell Arteritis diagnosis, Giant Cell Arteritis pathology, Polymyalgia Rheumatica
- 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.
- Published
- 2019