Pericardial effusion and aortitis as a manifestation of giant cell arteritis

Giant cell arteritis is a systemic vasculitis with segmentary vascular loca lisation, usually manifesting as temporal arteritis (Horton's disease). The predominant localisation in different vascular districts leads to clinical heterogeneity and poses a considerable diagnostic challenge. We describe a 77-year old woman with atypical presentation of giant cell arteritis, suff ering from fever, weight loss and fatigue, but without classical symptoms s uch as polymyalgias, arthralgias and headache. The findings of pericardial effusion and thickening of aortic wall in chest-CT suggested the diagnosis of giant cell arteritis, fully confirmed by the following biopsy and histol ogic examination of a macroscopically and palpatory normal arteria temporal is. Undergoing an appropriate corticosteroid-medication the patient has bee n free of symptoms since 8 months.