A Retrospective Study of Chinese Patients With Giant Cell Arteritis (GCA)

Abstract

A retrospective study was performed on 70 giant cell arteritis (GCA) patients in Peking Union Medical College Hospital (PUMCH). The aim of this study was to describe the clinical features of these Chinese GCA patients and explore the possible associated factors for severe ischemic manifestations. Medical charts of all patients were reviewed, and the demographic, clinical, and laboratory data were analyzed. The mean age at disease onset was 65.2 years old, and the ratio of male to female was 1:1. Fever and headache were most prominent symptoms at onset, which occurred in 51.4% and 30.0% of patients, respectively. Common manifestations at diagnosis were constitutional symptoms (85.7%), headache (68.8%), visual impairment (38.6%), jaw claudication (30%), scalp tenderness (30%), and concurrent polymyalgia rheumatic (27.1%). No significant difference in clinical manifestations between genders was observed. Comparisons between patients with and without severe ischemic manifestations including jaw claudication, permanent visual loss, or cerebrovascular accident had shown that fever and asthenia were significantly less frequent in patients with severe ischemic manifestations (P = 0.006 and 0.023, respectively), and the mean value of erythrocyte sedimentation rate (ESR) was significantly lower in patients with severe ischemic manifestations than patients without (P = 0.001). History of smoking was more frequent in patients with severe ischemic manifestations (P = 0.038).This is the largest group of GCA patients from China so far. When compared our data with patients reported in the literature, this series of GCA patients were younger and without female predominance. The clinical manifestations of patients in this report were similar to other studies except for a higher prevalence of constitutional symptoms. The results of this study indicated that lower systemic inflammatory response and the history of smoking might be associated with severe ischemic damages.

Giant cell arteritis presenting as bilateral anterior ischemic optic neuropathy: a biopsy-proven case report in Chinese patient

“…The epidemiological studies have rarely been addressed and according to Kobayashi et al, the prevalence in Japan is 1.47 per 100 000 [ 4 ]. Two large sample studies in China mainland showed the clinical manifestations of GCA in Chinese patients were similar to those previously described in literature [ 5 , 6 ]. Arteritic anterior ischemic optic neuropathy (A-AION) due to GCA, which accounting for 85% of cases of permanent vision loss [ 7 ], had not been reported in China so far, except for several presumed cases without biopsy published in non-English literature.…”

“…GCA represents a rare systematic granulomatous vasculitis in Asian, with fever and headache as the most prominent symptoms at onset [ 5 , 6 ]. An arteritic anterior ischemic optic neuropathy (A-AION) from inflammatory occlusion of posterior ciliary artery is the most common cause of permanent visual loss.…”

A Stab in the Dark: A Case Report of an Atypical Presentation of Giant Cell Arteritis (GCA)

“…Smoking may represent a cofactor, aiding rather than triggering GCA development [6] by impairing arterial endothelium and oestrogen synthesis [7]. Smoking has also been associated with more severe ischaemic symptoms [8].…”

Complete blood count reflecting the disease status of giant cell arteritis

“…Among these, cranial symptoms and fever are the most common. [ 2 ] Polymyalgia rheumatica and GCA represent either different manifestations of the same disease or overlapping conditions. Approximately 40% to 60% patients diagnosed with GCA also have polymyalgia rheumatica, [ 3 ] which is characterized by myalgia and arthralgia.…”

“…[ 1 ] The most severe complications of GCA are ischemic manifestations, such as permanent visual loss and stroke, which constitute 15%-30% of GCA cases [ 4 ] and leads to chronic disabilities among GCA patients. [ 2 ] For these patients, early initiation of high-dose GC therapy results in prompt remission of symptoms. [ 1 ] However, some patients show GC-resistant potential, that is, they have inadequate response to standard GC for induction of remission.…”