Quentin Gomes de Pinho1, Aurélie Daumas2, Audrey Benyamine3, Julien Bertolino3, Pascal Rossi3, Nicolas Schleinitz4, Jean-Robert Harlé4, Pierre André Jarrot5, Gilles Kaplanski5, Julie Berbis6, Brigitte Granel3. 1. Assistance Publique des Hôpitaux de Marseille (APHM), Hôpital Nord, Service de Médecine Interne, Aix-Marseille Université (AMU), Marseille, France. quentin.gomes-de-pinho@ap-hm.fr. 2. Assistance Publique des Hôpitaux de Marseille (APHM), Hôpital de la Timone, Service de Médecine Interne, Gériatrie et Thérapeutique, Aix-Marseille Université (AMU), Marseille, France. 3. Assistance Publique des Hôpitaux de Marseille (APHM), Hôpital Nord, Service de Médecine Interne, Aix-Marseille Université (AMU), Marseille, France. 4. Assistance Publique des Hôpitaux de Marseille (APHM), Hôpital de la Timone, Service de Médecine Interne, Aix-Marseille Université (AMU), Marseille, France. 5. Assistance Publique des Hôpitaux de Marseille (APHM), Hôpital de la Conception, Service de Médecine Interne et Immunologie Clinique, Aix-Marseille Université (AMU), Marseille, France. 6. Faculté de Médecine de la Timone, Laboratoire de Santé Publique, EA 3279, Centre d'étude et de Recherche sur les Service de Santé et la Qualité de vie, Aix-Marseille Université (AMU), Marseille, France.
Abstract
OBJECTIVE: Giant cell arteritis (GCA) is the most frequent vasculitis affecting adults aged > 50 years. Cardiac involvement in GCA is considered rare, and only a few cases of pericarditis have been reported. The aim of this study was to determine the characteristics and prognosis of GCA patients suffering from pericardial involvement at diagnosis. METHODS: We conducted a single-centre, retrospective chart review of patients with GCA in internal medicine departments (from 2000 to 2020). Patients were identified through a centralized hospital database. We retrospectively collected demographic, clinicobiological, histological, imaging, treatment and outcome data. Patients with pericardial effusion, defined as an effusion visible on the CT-scan performed at GCA diagnosis were compared to those without pericardial involvement. RESULTS: Among the 250 patients with GCA, 23 patients (9.2%) had pericardial effusion on CT-scan. The comparison between the groups revealed similar distribution of age, gender, cranial symptoms and ocular ischaemic complications. Patients with pericardial effusion had a higher frequency of weight loss. They also had lower haemoglobin levels and higher platelet levels (p = 0.006 and p = 0.002, respectively), and they more frequently had positive temporal artery biopsy. There were no differences concerning the treatment, relapses, follow-up duration or deaths. CONCLUSIONS: This case series sheds light on GCA as a cause of unexplained pericardial effusion or symptomatic pericarditis among adults aged > 50 years and elevated inflammatory biological markers. Fortunately, pericardial involvement is a benign GCA manifestation. In that context, the search for constitutional symptoms, cranial symptoms and associated signs of polymyalgia rheumatica is crucial for rapidly guiding GCA diagnosis.
OBJECTIVE: Giant cell arteritis (GCA) is the most frequent vasculitis affecting adults aged > 50 years. Cardiac involvement in GCA is considered rare, and only a few cases of pericarditis have been reported. The aim of this study was to determine the characteristics and prognosis of GCA patients suffering from pericardial involvement at diagnosis. METHODS: We conducted a single-centre, retrospective chart review of patients with GCA in internal medicine departments (from 2000 to 2020). Patients were identified through a centralized hospital database. We retrospectively collected demographic, clinicobiological, histological, imaging, treatment and outcome data. Patients with pericardial effusion, defined as an effusion visible on the CT-scan performed at GCA diagnosis were compared to those without pericardial involvement. RESULTS: Among the 250 patients with GCA, 23 patients (9.2%) had pericardial effusion on CT-scan. The comparison between the groups revealed similar distribution of age, gender, cranial symptoms and ocular ischaemic complications. Patients with pericardial effusion had a higher frequency of weight loss. They also had lower haemoglobin levels and higher platelet levels (p = 0.006 and p = 0.002, respectively), and they more frequently had positive temporal artery biopsy. There were no differences concerning the treatment, relapses, follow-up duration or deaths. CONCLUSIONS: This case series sheds light on GCA as a cause of unexplained pericardial effusion or symptomatic pericarditis among adults aged > 50 years and elevated inflammatory biological markers. Fortunately, pericardial involvement is a benign GCA manifestation. In that context, the search for constitutional symptoms, cranial symptoms and associated signs of polymyalgia rheumatica is crucial for rapidly guiding GCA diagnosis.
Authors: G G Hunder; D A Bloch; B A Michel; M B Stevens; W P Arend; L H Calabrese; S M Edworthy; A S Fauci; R Y Leavitt; J T Lie Journal: Arthritis Rheum Date: 1990-08
Authors: Bernhard Hellmich; Ana Agueda; Sara Monti; Frank Buttgereit; Hubert de Boysson; Elisabeth Brouwer; Rebecca Cassie; Maria C Cid; Bhaskar Dasgupta; Christian Dejaco; Gulen Hatemi; Nicole Hollinger; Alfred Mahr; Susan P Mollan; Chetan Mukhtyar; Cristina Ponte; Carlo Salvarani; Rajappa Sivakumar; Xinping Tian; Gunnar Tomasson; Carl Turesson; Wolfgang Schmidt; Peter M Villiger; Richard Watts; Chris Young; Raashid Ahmed Luqmani Journal: Ann Rheum Dis Date: 2019-07-03 Impact factor: 19.103
Authors: Hubert de Boysson; Aurélie Daumas; Mathieu Vautier; Jean-Jacques Parienti; Eric Liozon; Marc Lambert; Maxime Samson; Mikael Ebbo; Anael Dumont; Audrey Sultan; Bernard Bonnotte; Alain Manrique; Boris Bienvenu; David Saadoun; Achille Aouba Journal: Autoimmun Rev Date: 2018-02-07 Impact factor: 9.754
Authors: J C Jennette; R J Falk; P A Bacon; N Basu; M C Cid; F Ferrario; L F Flores-Suarez; W L Gross; L Guillevin; E C Hagen; G S Hoffman; D R Jayne; C G M Kallenberg; P Lamprecht; C A Langford; R A Luqmani; A D Mahr; E L Matteson; P A Merkel; S Ozen; C D Pusey; N Rasmussen; A J Rees; D G I Scott; U Specks; J H Stone; K Takahashi; R A Watts Journal: Arthritis Rheum Date: 2013-01