Goupil de Bouillé J, Lecouffe-Desprets M, Bigot A, Halimi J-M, Courtehoux M, Guilmot J-L, Breteau C, Diot E
Service de médecine interne, CHU de Tours, université François-Rabelais, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
EA-4245, service de néphrologie-immunologie clinique, CHU de Tours, université François-Rabelais, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
J Mal Vasc. 2015 May;40(3):200-5. doi: 10.1016/j.jmv.2015.02.003. Epub 2015 Mar 16.
We report a case of a 76-year-old woman with isolated unilateral Raynaud phenomenon revealing giant-cell arteritis with diffuse arterial lesions and bilateral renal artery stenosis. Doppler ultrasonography showed bilateral stenosis of the subclavian and axillary arteries. Angio-CT PET enlightened diffuse arterial lesions, mainly involving the aorta and the brachial and femoral arteries as well as bilateral renal ostial stenosis with right kidney ischemia. Diagnosis of giant-cell arteritis was made on the temporal artery biopsy. Corticosteroid therapy led to rapid clinical and radiological improvement. Clinical manifestations of giant-cell arteritis may be atypical. Diffuse arterial disease may exist in the absence of cephalic symptoms or significant inflammatory biological features. Ostial renal artery stenosis may induce potentially threatening renal ischemia.