[Large vessel vasculitis without aortitis in giant cell arteritis: About 4 cases].

INTRODUCTION

Giant cell arteritis (GCA) is the most common vasculitis after the age of 50. Large vessel vasculitis (LVV) is frequently observed in 40 to 70% of cases, primarily affecting the aorta. Extracranial LVV is scarcely described.

OBSERVATION: We present four cases of LVV-GCA without aortitis. LVV was found in 3 cases on PET-CT showing limb involvement, for the last case, CT scan revealed involvement of mesenteric artery. The diagnosis of GCA was confirmed in three of the four cases by temporal artery biopsy. In the last case, the diagnosis was made after PET-CT analysis and ophthalmological examination with a pathognomonic angiography. Three patients developed corticosteroid dependence and the last one was lost to follow-up.

CONCLUSION

LVV without aortitis evolution is rarely described. We report here 4 cases, 3 of whom became corticosteroid dependent. Larger cohort studies are needed to assess the prognosis and therapeutic impact of this particular phenotype of GCA.