Inaugural symptoms of Horton disease: a study of 260 patients

Purpose. - Horton disease or 'giant cell arteritis' is a known entity in it s typical form; the difficulty in diagnosis is due to the atypical signs an d symptoms. Methods. - We review 260 medical files presenting Horton disease between 19 79 and 1999 in five different departments: three internal medicine departme nts, one rheumatology department and one geriatric department. Results.- The study shows a female domination with a mean age of 75 years. Temporal artery biopsy was done on all patients. Ten patients presented a v ascular manifestation. The neurological manifestation was the first symptom in four patients. Five patients had cutaneous symptomatology, with positiv e temporal artery in three cases. Renal manifestation was present in two pa tients. Two symptoms are important to discuss because of their frequency: t he cough and the peripheral arthritis. We found nine observations with arth ritis affecting large joints and responding to nonsteroidal anti-inflammato ries with positive temporal artery biopsy in seven patients, and 21 observa tions manifesting by cough without radiological signs; in 57% of cases the temporal artery biopsy was positive, and the cough regressed with corticoid s. Conclusion. - These atypical symptoms have to be known to make a diagnosis and to begin a corticotherapy as soon as possible. (C) 2001 Editions scient ifiques et medicales Elsevier SAS.