Vasculitis & polymyalgia rheumatica
Further expanding the clinical spectrum of giant cell arteritis: Non-classical organ involvement and uncommon complications
Authors' conclusion
Beyond the classical cranial and extracranial patterns, which often coexist, a significant proportion of GCA patients may present with atypical or non-classical complications, sometimes as the initial manifestation.
Study context
- Population
- Consecutive patients with proven giant cell arteritis (GCA) diagnosed 2005–2024
- Participants
- 174 patients
- Outcome
- Frequency and spectrum of non-classical manifestations and other infrequent complications of GCA
Methodological detailsconsecutive cohort
- Consecutive cohort
Main finding
As reported in the abstract
One or more non-classical organ manifestations
GCA
29.9%
52 of 174
- Cardiac involvement (ischaemic heart disease or pericarditis)
- 7.5%
- Primary respiratory disease (pleural disease, sore throat, persistent dry cough, ILD, pulmonary inflammatory nodules)
- 13.8%
- Neurological complications beyond strokes (peripheral neuropathy, epilepsy, spinal cord infarction)
- 2.3%
- Gastrointestinal involvement
- 1.1%
- Increased 18F-FDG uptake in salivary glands
- 5.7%
Observational data: associations, not effects.
Further findings
Uncommon medium-to-large vessel involvement on PET-CT at diagnosis
- Renal artery vasculitis (without renal insufficiency or urinary abnormalities)
- 2.9%
- Asymptomatic splanchnic involvement (coeliac trunk or superior mesenteric artery)
- 4.6%
Other infrequent manifestations
- Secondary amyloidosis
- 1.1%
- Necrosis or involvement of scalp, tongue or lips
- 2.3%
- Carotidynia
- 5.2%
- Overt audiovestibular involvement (sensorineural hearing loss or vestibular dysfunction)
- 3.4%
- Musculoskeletal symptoms beyond PMR (peripheral arthritis, remitting distal extremity swelling with pitting oedema)
- 10.3%
- Diffuse increase in bone marrow 18F-FDG uptake
- 15.5%
- Polyautoimmunity
- 10.3%
Original publication
Further expanding the clinical spectrum of giant cell arteritis: Non-classical organ involvement and uncommon complications. Semin Arthritis Rheum. Published 12 August 2025. doi:10.
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