Giant Cell Arteritis: Clinical Features of Patients Visiting a Headache Clinic in Japan

• Published in: Internal Medicine Vol. 50; no. 16; pp. 1679 - 1682
• Main Authors: Imai, Noboru, Kuroda, Ryou, Serizawa, Masahiro, Konishi, Takashi, Kobari, Masahiro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2011
• Subjects: Aged; Aged, 80 and over; Female; giant cell arteritis; Giant Cell Arteritis - diagnosis; Giant Cell Arteritis - ethnology; Giant Cell Arteritis - therapy; Headache - diagnosis; Headache - ethnology; Headache - therapy; Humans; Japan - ethnology; jaw claudication; Male; Outpatient Clinics, Hospital; polymyalgia rheumatica; Retrospective Studies; visual loss; Japan
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.50.5205

Objective The first symptom of giant cell arteritis (GCA) is usually a headache. Japan has a low prevalence of GCA, and clinical features of this disorder have not been fully investigated. We conducted a retrospective evaluation of clinical features in patients with giant cell arteritis who visited a headache clinic in Japan. Methods Clinical and demographic data were obtained from clinical examinations, face-to-face interviews, and hospital records. Patients Subjects comprised 19 patients (9 men, 10 women). Results Mean age at disease onset was 78.1 ± 4.8 years (range, 71-86 years). Seventeen of 19 patients (89.5%) had consulted other medical institutions before consulting our hospital, but only 2 of those patients had been diagnosed with GCA at these medical institutions. Manifestations at disease onset included headache (89.5%), ear pain (5.3%), and jaw pain (5.3%). Ocular manifestations were reported in 2 patients (10.5%). No loss of vision occurred. One patient showed trigeminal nerve palsy involving the third division of the nerve. Jaw claudication was observed in 3 patients (15.8%). Concomitant polymyalgia rheumatica was seen in 3 patients (15.8%). No patient showed upper respiratory tract symptoms, arm claudication, or aortic aneurysms. Conclusion Although most patients had consulted other medical institutions before consulting our hospital, they were not diagnosed with GCA at these institutions. Infrequent clinical findings of GCA and lack of symptoms other than headache may contribute to the high rate of unrecognized and misdiagnosed cases of GCA.