Journal List > J Korean Rheum Assoc > v.17(3) > 1003738

Seo, Hur, Kim, Jeon, Baek, Kim, and Lee: A Case of Atypical Giant Cell Arteritis Presenting as Raynaud's Phenomenon and Diagnosed by Random Temporal Artery Biopsy

Abstract

Giant cell arteritis (GCA) is a chronic vasculitis that mainly involves the cranial branches of arteries, and typically it presents with a cephalic sign such as a new headache, jaw claudication and/or visual symptoms. Although the tender, swollen or beaded arteries are adequate sites for biopsy, random temporal artery biopsy should be performed in all the patients suspected of suffering with GCA and even if cephalic signs are not present. Several cases of typical GCA have been reported in Korea, but so far there have been no reports of an atypical case presenting with Raynaud's phenomenon, and the patient was diagnosed by random temporal artery biopsy. Here we describe a case that showed the typical pathological findings of GCA in an asymptomatic temporal artery. The patient complained of only Raynaud's phnomenon and the patient was without any cephalic symptoms.

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Fig. 1.
This scan shows the vessel wall thickening and skip area of the left subclavian artery and significant stenosis due to symmetrical vascular wall thickening of the axillary artery.
jkra-17-278f1.tif
Fig. 2.
Granulomatous and lymphocytic inflammation of the adventitia and medial wall of the temporal artery. The arrow shows a disruption of the elastica due to immunologically-mediated destruction of the elastic layer (Elastic tissue stain X 100).
jkra-17-278f2.tif
Fig. 3.
PET shows the extent of the vascular involvement, such as both the subclavian (arrow) and axillary arteries (dotted arrow). The 18-Fluorodeoxyglucose (FDG) uptake was graded on a 3-point scale.
jkra-17-278f3.tif
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