Objective: Giant cell arteritis (GCA) is commonly known for its clinical presentation of temporal arteritis. However, GCA affects large arteries, predominantly the aorta and its proximal branches, in up to 75% of cases. We describe the clinical presentation and diagnostic test results of patients with large-vessel GCA.

Methods: Case description of 11 patients with large-vessel GCA diagnosed consecutively in our hospital.

Results: The clinical presentation of large-vessel GCA is highly variable, from systemic inflammation to aortic rupture. Imaging shows variable abnormalities, but 18-fluorodeoxyglucose positron-emission-tomography (18-FDG PET) seems to be a sensitive and reasonably specific diagnostic test for large-vessel GCA.

Conclusion: Large-vessel GCA is a clinically heterogeneous condition. 18-FDG PET should be considered in the diagnostic work-up of suspected cases. Since this disorder has a high complication rate, and is responsive to treatment with corticosteroids, a high level of clinical suspicion is warranted.

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http://dx.doi.org/10.1016/j.jvs.2008.04.054DOI Listing

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