CASE REPORT   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2021 September;180(9):506-9

DOI: 10.23736/S0393-3660.20.04510-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Large vessel vasculitis: Takayasu arteritis or giant cell arteritis - fine line between them

Arsénio M. BARBOSA ✉, Nuno MELO, Bruno BESTEIRO, Filipa GOMES, Jorge ALMEIDA

Department of Internal Medicine, São João Hospital, Porto, Portugal

Vasculitides refers to the presence of inflammation of the vessel walls and are classified according to he 2012 Chapel Hill Conference Criteria. Takayasu arteritis (TAK) and Giant cell arteritis (GCA) are large vessel vasculitides (LVV) and some authors suggest that could be spectrum of the same disease. A 62-year-old male patient referred to our hospital with dry cough and fever 3 weeks before admission. He was medicated with levofloxacin to a presumptive respiratory tract infection with no resolution. The patient presented with normochromic anemia and elevated inflammatory markers. It was realized an extensive workup diagnosis. Cultures, serology and CT-scan excluded infection or neoplasia. Finally, we performed a positron emission-tomography (PET-scan) that showed uptake along the length of the walls of the aorta, carotid, brachiocephalic, subclavian and common iliac arteries, resembling TAK. A diagnosis of LVV was made and the patient started steroids resulting in clinical and analytical response. He was discharged and now he is followed in an outpatient basis, tolerating steroids taper. TAK and GCA have been suggested as two separate entities, however, it has been proposed that TAK and GCA compromise a spectrum of the same disease. Considering epidemiology and arterial involvement, our patient could be classified as overlap TAK/CGA or GCA with LVV.

KEY WORDS: Vasculitis; Takayasu arteritis; Giant cell arteritis; Fever