Giant Cell Arteritis (Horton's Disease) of the Axillary Artery — Case Reports

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Abstract
The authors recently observed 2 elderly female patients with ischemic pain of the upper extremity as the first manifestation of giant cell arteri tis. They presented with rest pain of both upper extremities and even gan grene of the thumb in 1 case. Subcla vian and radial pulses were absent while peripheral pulses in the lower limbs were preserved. The angiogra phy was so typical that the diagnosis of inflammatory arteritis was made, despite negative temporal artery bi opsy. The patient with thumb gangrene was successfully operated on, the oc clusive axillary lesions being by passed by a long venous carotidohu meral bypass graft. A biopsy of the axillary artery showed a granuloma tous lymphoplasmocellular infiltra tion. A high-dose corticotherapy (24 mg daily) was begun in both cases, with dramatic improvements of gen eral state, lowering of the erythrocyte sedimentation rate, and even reappa rition of a reduced radial pulse in 1 patient. The authors discuss the incidence, symptoms, diagnosis, and treatment of systemic giant cell arteritis, with special attention to extracranial in volvement. These case reports may broaden the knowledge of the diverse manifestations of giant cell arteritis and of its systemic character with widespread vascular involvement.