Pulmonary nodules in a patient with Giant Cell Arteritis

Pulmonology. 2019 Mar-Apr;25(2):109-113. doi: 10.1016/j.pulmoe.2018.12.005. Epub 2019 Feb 10.

Abstract

Giant Cell Arteritis (GCA) is a common systemic vasculitis that involves medium and large arteries, most frequently extracranial branches of the carotid artery. Prompt diagnosis and treatment is essential to prevent devastating complications, such as blindness, stroke and aortic aneurysm or dissection. Typical symptoms include headache, temporal artery tenderness and jaw claudication. On rare occasions patients present with complaints related to pulmonary involvement. These include interstitial infiltration, pulmonary nodules, pleural effusion and pulmonary haemorrhage. The authors report the case of a 74-year-old man who presented with symptoms compatible with GCA confirmed by temporal biopsy, and pulmonary nodules. These lesions were biopsied and histological exam confirmed features compatible with systemic vasculitis. The lesions resolved after two months of steroid treatment. This case shows that we should be aware of atypical GCA manifestations.

Keywords: Giant Cell Arteritis; Horton's disease; Large-vessel vasculitis; Pulmonary nodules; Systemic vasculitis; Temporal Arteritis.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Biopsy
  • Giant Cell Arteritis / complications
  • Giant Cell Arteritis / diagnosis
  • Giant Cell Arteritis / pathology*
  • Humans
  • Male
  • Multiple Pulmonary Nodules / diagnostic imaging*
  • Multiple Pulmonary Nodules / etiology
  • Multiple Pulmonary Nodules / pathology
  • Prednisolone / administration & dosage
  • Prednisolone / therapeutic use
  • Systemic Vasculitis / drug therapy
  • Systemic Vasculitis / pathology*
  • Temporal Arteries / pathology*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Prednisolone