Coronary and Aortic Involvement as Initial Manifestations of Possible Giant Cell Arteritis in a Patient Without Cardiovascular Comorbidities

Abstract

Giant cell arteritis (GCA) is the most common primary vasculitis worldwide, affecting mainly older adult women. GCA affects medium- and large-size arteries, most commonly the extracranial branches of the carotid artery. The gold standard for the diagnosis of GCA is temporal artery biopsy; lesions may include fragmentation of the internal elastic lamina, multinucleated giant cells, and lymphohistiocytary adventitial infiltrate. Inflammation is focal and segmental ("skipped lesions"), which may lead to false-negative biopsy results. We wish to report a patient who we have diagnosed with possible GCA with coronary involvement and aortitis, whose disease debuted without classic symptoms...