Malattie reumatiche in geriatria. Arterite di Horton: Caso clinico

F.C., 65 year-old patient comes to our out-patients' department because of a throbbing headache associated with scalp pain, difficult mastication, pain in neck's lateral area and general symptoms as asthenia, inappetence and depression. After six months the aching symptoms became persistent and associated with the main joints' pain and stiffness. The careful anamnesis, medical examination and laboratory findings made the correct diagnosis of Giant Cell Arteritis possible, later confirmed by the temporal artery biopsy. Giant Cell Arteritis is a systemic vasculitis characterized by granulomatous inflammation of the aorta and its main vessels. It should be supposed in old patients who suffer of recent headache, jaw claudication, eye diseases and if there are symptoms referred to Polymyalgia Rheumatica. The gold standard for the Giant Cell Arteritis's diagnosis are the distinctive byoptic traits of the temporal artery although the American College of Rheumatology has fixed criteria that allow to diagnose cranial arteritis even if the histological pattern is not characteristic. Early diagnosis is necessary because prognosis depends on the timeliness of treatment: this kind of arteritis can complicate with vision loss and cerebrovascular accidents.