Steroid sensitive systemic disease with anaemia in the elderly: a manifestation of giant cell arteritis?

Nine elderly patients presented with features of a multisystem disorder thought to be either a connective tissue disease of undefined type or disseminated malignancy. Associated features were a normochromic anaemia, raised erythrocyte sedimentation rate (ESR) (or plasma viscosity) and raised serum alkaline phosphatase levels. None had symptoms to suggest either giant cell arteritis or polymyalgia rheumatica. Temporal artery biopsy was performed before trial of corticosteroid therapy in four, and two showed giant cell arteritis. All nine responded dramatically to corticosteroids and the anaemias resolved. One died after 6 y, and the rest are well after 1 to 7 y.