Giant cell arteritis: A clinical and pathological study.
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Date
2010-01
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Abstract
Background. Giant cell arteritis is a vasculitis affecting
large- and medium-calibre vessels. It is not uncommon in the
West and there are many large series in the literature.
However, there are very few reports of giant cell arteritis
among Indian patients.
Methods. We did a retrospective study of 9 Indian
patients (5 men and 4 women; age range 59–81 years [mean
and median 70 years]) who had had a temporal artery biopsy
for suspected giant cell arteritis at a tertiary care hospital.
Results. Eight patients had biopsy-proven giant cell arteritis.
The common presenting features were pyrexia of unknown
origin (4), headache (6) and blurring of vision (2). The erythrocyte
sedimentation rate was elevated and ranged from 25
to 120 mm at the end of the first hour (mean 96, median
105). The C-reactive protein level, which was available in 5
cases, was raised. Giant cells and inflammatory cells were seen
in 7 of 8 temporal artery biopsies; a transmural lymphocytic
and neutrophil infiltrate without giant cells was present in
1 case. All patients were treated with steroids and they
responded well.
Conclusion. Temporal arteritis is probably under-recognized in India. Pyrexia is a common presenting feature of the disease; temporal arteritis should be considered in the differential diagnosis of elderly patients with pyrexia of unknown origin.
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Vankalakunti Mahesha, Dharmanand B G, Chandra Suresh, Pai Sanjay A. Giant cell arteritis: A clinical and pathological study. National Medical Journal of India. 2010 Jan-Feb; 23(1): 18-20.