Aortic aneurysm and dissection are not associated with an increased risk for giant cell arteritis/ polymyalgia rheumatica
Michael Ehrenfelda, Rafael Bitzura, Jacob Schneidermanb, Aram Smolinskyc, Yechezkel Sidia, Hanan Gura
a Chaim Sheba
Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv
University, Israel: Department of Medicine C, b Department of Vascular Surgery, c Department of Cardiac Surgery
Correspondence to: Dr Hanan Gur, Department of Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel 52621 (e-mail: hanang{at}post.tau.ac.il)
Submitted 15 July 1999;
Accepted 7 December 1999
It has recently been claimed that giant cell arteritis (GCA) is
associated with a markedly increased risk of aortic aneurysm formation
or rupture. In the present study, the opposite approach was taken, by
looking for the incidence of GCA and polymyalgia rheumatica (PMR) in
patients with aortic aneurysm, aortic dissection, or both (AA/D). The
records of 315 consecutive patients admitted with the diagnosis of AA/D
were reviewed. In addition, follow up information was obtained in 82 patients by examination in the outpatient clinic. After careful
examination and assessment of clinical and laboratory data, it was
found that none of the 82 patients who survived hospitalisation and
were available for examination had GCA or PMR. Moreover, review of the
retrospective data available from hospital records of the total
consecutive 315 patients with AA/D failed to find any patient with a
diagnosis of GCA/PMR. In conclusion, the present study did not find an
increased prevalence of GCA/PMR among a cohort of Israeli patients with
AA/D. Therefore, it is suggested that a thorough investigation aiming
to diagnose GCA/PMR is not cost effective in most of the elderly
patients presenting with AA/D.
Keywords: giant cell arteritis; polymyalgia rheumatica; aortic aneurysm; aortic dissection
© 2000 by The Fellowship of Postgraduate Medicine
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