Giant Cell Arteritis or Formerly Known as Horton's Disease When the Puzzle is Complete: A Case Report

Abstract

Giant cell arteritis, formerly known as Horton's disease, is a vasculitis affecting the large vessels, specifically the aorta, with a preference for the supra-aortic trunks. Its etiology remains unknown, but two risk factors have been identified: a genetic predisposition and the hypothesis of a likely viral infectious agent. The pathophysiology is increasingly understood due to advances in immunological and genetic knowledge. It generally affects patients over 50 years old and clinically manifests as headaches, scalp paresthesias, and jaw claudication, evolving in a context of low-grade fever and general deterioration. It is often associated with polymyalgia rheumatica, and the most feared complication is blindness. Clinical examination reveals a decrease or abolition of temporal pulses. Diagnosis is histological, via temporal artery biopsy or, failing that, through a PET-CT scan. The condition is highly sensitive to corticosteroids, with a favorable prognosis under treatment. However, relapses can occur during corticosteroid tapering, potentially necessitating a minimally effective maintenance dose of at least 1 mg/day of corticosteroids such as prednisone. Our work consists of an observation of a patient reporting a florid and complete picture of Horton's disease both clinically and biologically with significant radiological manifestations.