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PET FDG CT is useful for giant-cell arteritis with isolated cough

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Abstract

Giant cell arteritis (GCA) is a chronic vasculitis of large- and medium-sized vessels. The most frequent symptoms are temporal headaches, scalp tenderness, jaw claudication and polymyalgia rheumatica in 35% of patients. Atypical presentation with dry cough is very rare and could be isolated making the diagnosis difficult. Initial imaging including PET-CT could be helpful. Literature review yielded 13 case reports with available data and one case series which focused on cough and which were all be included in this study. Most of the cases included males (n = 8), with mostly isolated cough or associated to fever and weight loss. Angio-CT of aortic wall was mostly normal, whereas FDG PET-CT showed in all available cases abnormal arterial thoracic uptake. Temporal artery biopsy was almost suggestive of GCA in all available cases. Cough was steroid responsive usually within few days in all cases without any need of combined therapy. Giant cell arteritis is the most common large-vessel vasculitis over the age of 50 in western countries. Isolated dry cough is extremely rare and encountered in less than 5% of cases.

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References

  1. Mekinian A, Djelbani S, Viry F, Fain O, Soussan M (2016) Usefulness of imaging in large vessel vasculitis. Rev Med Interne 37(4):245–255

    Article  CAS  PubMed  Google Scholar 

  2. Soussan M, Nicolas P, Schramm C, Katsahian S, Pop G, Fain O, Mekinian A (2015) Management of large-vessel vasculitis with FDG-PET: a systematic literature review and meta-analysis. Medicine (Baltimore) 94(14):e622

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sammel AM, Hsiao E, Schembri G, Nguyen K, Brewer J, Schrieber L, Janssen B, Youssef P, Fraser CL, Bailey E, Bailey DL, Roach P, Laurent R (2019) Diagnostic accuracy of PET/CT scan of the head, neck and chest for giant cell arteritis: the double-blinded giant cell arteritis and PET scan (GAPS) study. Arthritis Rheumatol 8:1319

    Article  Google Scholar 

  4. Olopade CO, Sekosan M, Schraufnagel DE (1997) Giant cell arteritis manifesting as chronic cough and fever of unknown origin. Mayo Clin Proc 72(11):1048–1050. https://doi.org/10.4065/72.11.1048

    Article  CAS  PubMed  Google Scholar 

  5. Joomaye Z, Sotto A, Jourdan J (1997) Isolated prolonged cough caused by Horton’s disease. Rev Mal Respir 14(1):59–60

    CAS  PubMed  Google Scholar 

  6. Walsh SJ, McClelland AJ, Owens CG, Callender ME (2001) Fever and dry cough in a patient with a prosthetic heart valve. An interesting presentation of temporal arteritis. Rheumatology (Oxford) 40(6):714–715

    Article  CAS  PubMed  Google Scholar 

  7. Hellmann DB (2002) Temporal arteritis: a cough, toothache, and tongue infarction. JAMA 287(22):2996–3000

    Article  PubMed  Google Scholar 

  8. Karagiannis A, Mathiopoulou L, Tziomalos K, Kontotasios K, Skaperdas A, Florentin M, Amplianitis IK, Athyros VG (2006) Dry cough as first manifestation of giant-cell arteritis. J Am Geriatr Soc 54(12):1957–1958

    Article  PubMed  Google Scholar 

  9. Cunha BA, Syed U, Hamid N (2006) Fever of unknown origin caused by late-onset rheumatoid arthritis. Heart Lung 35(1):70–73

    Article  PubMed  Google Scholar 

  10. Kassem H, El Gharbi T, Hamadi K, Dresco E, Turner L (2011) Chronic cough as the presenting feature of temporal arteritis. Rev Med Interne 32(6):e76–e78

    Article  CAS  PubMed  Google Scholar 

  11. Zenone T, Puget M (2013) Dry cough is a frequent manifestation of giant cell arteritis. Rheumatol Int 33(8):2165–2168

    Article  PubMed  Google Scholar 

  12. Kondo T, Ohira Y, Uehara T, Noda K, Tsukamoto T, Ikusaka M (2018) Cough and giant cell arteritis. QJM 111(10):747–748

    Article  CAS  PubMed  Google Scholar 

  13. Sagar D, Sagar AS, Soussi S (2019) Chronic cough in a 70-year-old woman. Chest 155(6):e171–e174

    Article  PubMed  Google Scholar 

  14. Mesquita A, Camara L, Patrício C, Brotas V (2020) Boundaries of a systemic disease: a protean presentation of giant cell arteritis. BMJ Case Rep 13(3):e232234

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hori H, Kobashigawa T, Fukuchi T, Sugawara H (2020) Giant cell arteritis manifested by chronic dry cough. BMJ Case Rep 13(6):e234734

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hubbard D, Bindiganavile SH, Divatia M, Bhat N, Lee AG (2021) Dry nonproductive cough as the presenting symptom of giant cell arteritis. J Neuroophthalmol 41(4):e746–e748

    Article  PubMed  Google Scholar 

  17. Azzam O, Hubble D, Prentice D (2022) Cough as a clinical manifestation of large vessel vasculitis. Intern Med J 52(3):488–490

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Nuclear Medicine Department, Kremlin Bicetre Hospital, APHP, Kremlin Bicetre, France

    Florent L. Besson

  2. Service de Medicine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU i2), Sorbonne Université, AP-HP, Hôpital Saint-Antoine, 75012, Paris, France

    Arsene Mekinian

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  1. Florent L. Besson
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  2. Arsene Mekinian
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Correspondence to Arsene Mekinian.

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Besson, F.L., Mekinian, A. PET FDG CT is useful for giant-cell arteritis with isolated cough. Rheumatol Int 43, 2333–2336 (2023). https://doi.org/10.1007/s00296-023-05395-2

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  • DOI: https://doi.org/10.1007/s00296-023-05395-2

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