A case of silent giant cell arteritis involving the entire aorta, carotid artery and brachial artery screened by integrated PET/CT
We report a case of giant cell arteritis involving the aorta and several large arteries identified by integrated positron emission tomography (PET)/computed tomography (CT) obtained in a patient with a high erythrocyte sedimentation rate (ESR). A 63-year-old man with anemia and a high ESR noted on a regular medical examination was transferred to our department. The patient complained of only a low-grade general weakness for several months; there were no specific symptoms or signs. A PET was recommended. The image showed strong 18F-fluorodeoxyglucose (18F-FDG) uptake at the ascending aorta, aortic arch, descending aorta, thoraco-lumbar aorta, brachial artery, and the carotid artery wall, bilaterally. Suspicious for large-vessel vasculitis, a temporal artery biopsy was performed, which confirmed giant cell arteritis. After treatment with prednisolone, the high ESR and anemia resolved, and 18F-FDG uptake decreased on follow-up integrated PET/CT.
KeywordsGiant cell arteritis Positron-emission tomography
- 3.Hellmann DB, Hunder GG (2005) Giant cell arteritis and polymyalgia rheumatica. In: Harris ED Jr, Budd RC, Firestein GS, Genovese MC, Sergent JS, Ruddy S, Sledge CB (eds) Kelly’s textbook of rheumatology, 7th edn. Elsevier Saunders, Philadelphia, pp 1343–1356Google Scholar
- 7.Bley TA, Wieben O, Uhl M et al (2005) High-resolution MRI in giant cell arteritis; imaging of the wall of the superficial temporal artery. Am J Roentgenol 184:283–287Google Scholar
- 9.Blockmans D (2002) Utility of imaging studies in assessment of vascular inflammation. Clevel Clin J Med 69(Suppl 2):SII 95–SII 99Google Scholar