Summary
Pulmonary involvement is rare in giant cell arteritis (GCA). Only a few cases have been reported, manifested by interstitial infiltration, pulmonary nodules, pulmonary artery vasculitis, and granuloma formation. Moreover, only 3 previous cases of pleural effusion associated with GCA have been described. Herein we report a 67-year-old woman with biopsy-proven temporal arteritis, presented with prolonged fever, weight loss, cough and pleural effusion. ELISA test for the presence of anti- proteinase-3 antibodies was negative. The importance of the anti-neutrophil cytoplasmic-antibodies (ANCA) examination in the differential diagnosis from other vasculitides with pulmonary involvement is discussed.
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Machado, E.B.V., Michet, C.J., Ballard, D.J. et al. Trends in incidence and clinical presentation of temporal arteritis in Olmstead County, Minnesota, 1950–1985. Arthritis Rheum 1988, 31, 754–749.
Horton, B.T., Magath, B.T., Brown, G.E. An undescribed form of arteritis of the temporal vessels. Proc Staff Meet Mayo Clin 1932, 7, 700–701.
Soderstrom, C.W., Seehafer, J.R. Bilateral scalp necrosis in temporal arteritis: A rare complication of Horton's disease. Am J Med 1976, 61, 541–546.
Healey, L.A. Polymyalgia rheumatica and giant cell arteritis. In: Arthritis and Allied Conditions. Eds: McCarthy, D.J., Koopman, W.J., Philadelphia, Lea & Febiger, 1993, 1377–1380.
Dare, B., Byrne, E., Robertson, A. Acute lingual ischemia complicating temporal arteritis. Med J Aust 1981, 1, 534.
Klein R.G., Hunder G.G., Stanson A.W., Sheps S.G. Large artery involvement in giant cell arteritis. Ann Int Med 1975, 83, 806–812.
Sonnenblick M., Nesher G., Rosin A. Nonclassical involvement in temporal arteritis. Semin Arthritis Rheum 1989, 19, 183–190.
Warrel D.A., Godfrey S., Olsen E.G.J. Giant cell arteritis with peripheral neuropathy. Lancet 1968, 1, 1010–1013.
Kramer M.R., Nesher G., Sonnenblick M. Corticoid responsive hearing loss in giant cell arteritis. J Laryngol Otol 1988,102, 524–525.
Golbus J., mcCune W.J. Giant cell arteritis and peripheral neoropathy: a report of 2 cases and review of the literature. J Rheumatol 1987, 14, 129–134.
Leong A.S.Y., Alp M.H. Hepatocellular disease in the giant cell arteritis/polymyalgia rheumatica syndrome. Ann Rheum Dis 1981, 40, 92–95.
Lenner P., Lundgren E. Giant lymph node hyperplasia (Castelman's disease) associated with temporal arteritis. Scand J Haematol 1981, 27, 263–266.
Elling H., Kristensen I.B. Fatal renal failure in polymyalgia rheumatica caused by disseminated giant cell arteritis. Scand J Rheumatol 1972, 9, 206–208.
Calmia K.T., Hunder G.G. Giant cell arteritis (temporal arteritis) presenting as fever of undetermined origin. Arthritis Rheum 1981, 24, 1414–1418.
Karam G.H., Fulmer J.D. Giant cell arteritis presenting as interstitial lung disease. Chest 1982, 82, 781–784.
Larson T.S., Stephen H., Hepper N.G.G., Hunder G.G. Respiratory tract symptoms as a clue to giant cell arteritis. Ann Int Med 1984, 101, 594–597.
Bradley J.D., Pinnals R.S., Blumenfeld H.B., Poston W.M. Giant cell arteritis with pulmonary nodules. Am J Med 1984, 77,135–140.
Kramer M.R., Melzer E., Nesher G., Sonnenblick M. Pulmonary manifestations of temporal arteritis. Eur J Respir Dis 1987, 7, 430–433.
Ladanyi M., Fraser R.S. Pulmonary involvement in giant cell arteritis. Arch Pathol Lab Med 1987, 111, 1178–1180.
Doyle L., McCwilliam L., Hasleton P.S. Giant cell arteritis with pulmonary involvement. Br J Dis Chest 1988, 82, 88–92.
Nishino H., DeRemee R.A., Rubino F.A., Parisi J.E. Wegener's granulomatosis associated with vasculitis of the temporal artery: report of five cases. Mayo Clin Proc 1993, 68, 115–121.
Sieber S.C., Cuello B., Gelfman N.A., Garfinkel H.B. Pulmonary capillaritis and glomerulonephritis in an antineutrophil cytoplasmic antibody-positive patient with prior granulomatous aortitis. Arch Pathol Lab Med 1990, 114, 1223–1226.
Amato M.B., Barbas C.S., Delmonte V.C., Carvalho C.R. Concurrent Churg-Strauss syndrome and temporal arteritis in a young patient with pulmonary nodules. Am Rev Respir Dis 1989, 139, 1539–1542.
Hoffman G.S. Wegener's granulomatosis. Curr Opin Rheumatol 1993, 5, 11–17.
Rasmussen N., Sjolin N., Isaksson B., Bygren P., Wieslander J. An ELISA for the detection of antineutrophil cytoplasmic antibodies (ANCA). J Immunol Meth 1990, 127, 129–145.
Romero S., Vela P., Padilla I. et al. Pleural effusion as a manifestation of temporal arteritis. Thorax 1992, 47, 398–399.
Ramos A., Laguna P., Cuervas V. Pleural effusion in giant cell arteritis. Ann Int Med 1992, 116, 957.
Glover M.U., Muniz J., Bessone L. et al. Pulmonary artery obstruction due to giant cell arteritis. Chest 1987, 91, 924–925.
Van der Woude F.J., Rasmussen N., Lobatto S. et al. Autoantibodies against neutrophils and monocytes: Tool for diagnosis and marker of disease activity in Wegener's granulomatosis. Lancet 1985, I, 425–429.
Niles J.L., McCluskey R.T., Ahmad M.F., Amin Arnaout M. Wegener's granulomatosis autoantigen in a novel neutrophil serine proteinase. Blood 1989, 74, 1888–1893.
Falk R.J., Jennette J.C. Anti-neutrophil cytoplasm autoantibodies with specificity for myeloperoxidase in patients with systemic vasculitis and idiopathic necrotizing and crescentic glomerulonephritis. N Eng J Med 1989, 318, 1641–1657.
Niles J. Value of tests for antineutrophil cytoplasmic autoantibodies in the diagnosis and treatment of vasculitis. Curr Opin Rheumatol 1993, 5, 18–24.
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Gur, H., Ehrenfeld, M. & Izsak, E. Pleural effusion as a presenting manifestation of giant cell arteritis. Clin Rheumatol 15, 200–203 (1996). https://doi.org/10.1007/BF02230342
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DOI: https://doi.org/10.1007/BF02230342