Head and neck giant cell arteritis: an autoimmune disease with many faces. (2nd September 2017)

• Record Type: Journal Article
• Authors: Wirth, Markus; Schirmer, Lucas; Hofauer, Benedikt; Lenschow, Magdalena; Loos, Daria; Thuermel, Klaus; Knopf, Andreas
• Is Part Of: Acta oto-laryngologica. Volume 137:Number 9(2017)
• Page Start: 986
• Page End: 991
• Publication Date: 2017-09-02
• Subjects: Giant cell arteritis -- head and neck -- atypical manifestation -- amaurosis -- diagnostic pathway; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2017.1314010
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: Conclusion: A high rate of infrequent presentations of giant cell arteritis were seen in the ENT department and should be anticipated as a differential diagnosis in every older patient with odynophagia with high CRP values without cause in thorough ENT examination. Objective: To describe the clinical manifestation of head and neck giant cell arteritis and to derive a diagnostic pathway covering atypical cases. Method: Single-center, retrospective analysis of cases with GCA in the head and neck region (HN-GCA) (2002–2012) to describe the clinical presentation and to derive a diagnostic pathway covering manifestations presenting to an ENT department. Results: Sixty-five patients were newly diagnosed with HN-GCA in the department of otolaryngology, ophthalmology and neurology. The most frequent symptoms were loss of vision (83%) and new onset headache (63%). Eight patients (12%) presented with infrequent manifestations, predominantly in the department of otorhinolaryngology. The most common atypical presentation (50%) was odynophagia in conjunction with high CRP values misleading to an infectious cause and delaying diagnosis. A diagnostic pathway for GCA was derived based on the ACR classification criteria and the clinical findings.