LARGE VESSEL VASCULITIS WITHOUT TEMPORAL ARTERY INVOLVEMENT - ISOLATED FORM OF GIANT-CELL ARTERITIS

Diffuse arterial involvement in giant cell arteritis (GCA) is well rec ognized. By contrast, GCA clinically isolated to large vessels without cephalic, rheumatologic or systemic symptoms represents a much rarer manifestation of the disease. We report the cases of 4 elderly women p resenting with a diffuse and symptomatic occlusive disease without the typical signs of temporal arteritis, in whom biological, angiographic or pathological findings were suggestive of GCA. Medium to high dose oral corticosteroids were given to the 4 patients, in combination with various revascularization procedures, allowing a fair clinical respon se. Large vessel arteritis should be considered in elderly women with diffuse non-atherosclerotic occlusive disease and elevated erythrocyte sedimentation rate, even if typical features of GCA are lacking. In t hose cases, a long-term treatment with corticosteroids is mandatory, b ut surgical or angioplastic revascularization is often required.