Rheumatology Advance Access originally published online on July 14, 2008
Rheumatology 2008 47(9):1406-1408; doi:10.1093/rheumatology/ken258
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Prognosis of large-vessel giant cell arteritis
1Medical Centre for Rheumatology Berlin-Buch and 2Department of Statistics, Berlin Tumour Centre, Berlin, Germany.
Correspondence to: W. A. Schmidt, Medical Centre for Rheumatology Berlin-Buch, Karower Str. 11, 13125 Berlin, Germany. E-mail: schmidt.wa{at}t-online.de
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Abstract |
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Objective. The prognosis of large-vessel GCA (LV-GCA) has not yet been investigated. How does it compare to GCA without arm vasculitis (GCA controls)?
Methods. Charts of 53 LV-GCA patients and 53 GCA controls were reviewed following a predetermined protocol. Telephone interviews of patients or their primary care physicians were conducted. Forty LV-GCA patients underwent follow-up duplex ultrasound examinations of proximal arm arteries.
Results. The mean observation time was 50 (S.D. ± 31) months. None of the LV-GCA patients developed ischaemic arm complications. In 30%, proximal arm artery wall swelling disappeared completely. It decreased in 53%. In 8% it remained unchanged, in 5% it increased and in 5% arteries occluded with collateral flow. After the start of treatment, anterior ischaemic optic neuropathy developed neither in LV-GCA patients nor in GCA controls, amaurosis fugax occurred in 4 and 6%, arterial hypertension in 53 and 66%, strokes in 9 and 9%, myocardial infarction in 2 and 2%, diabetes mellitus in 30 and 25%, osteoporosis in 38 and 23%, and osteoporotic fractures in 15 and 4%, respectively. Mean corticosteroid dose was 3.7 mg/day. Mean duration of therapy was 42 months. All differences were insignificant. Four LV-GCA patients developed vasculitic popliteal artery stenoses.
Conclusions. The prognosis of LV-GCA is benign with regard to ischaemic complications. Proximal artery wall swelling decreases in most cases. Its course is similar to GCA without proximal arm arteritis.
KEY WORDS: Giant cell arteritis, Ultrasonography, Colour Doppler ultrasonography, Follow-up studies
Submitted 10 February 2008;
revised version accepted 13 June 2008.
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