Giant cell arteritis presenting as chronic cough and prolonged fever

Abstract

A 62-year-old man presented with a 3-month history of chronic non-productive cough and unexplained fever. Further questioning revealed that he had headaches and myalgia. Bilateral thickened temporal arteries were noted on physical examination. The erythrocyte sedimentation rate was 96 mm in 1 h. A biopsy specimen of the left temporal artery showed inflammatory changes consistent with the diagnosis of giant cell arteritis. Commencement of prednisolone resulted in rapid and dramatic resolution of his symptoms. Physicians should be aware of respiratory symptoms in patients with giant cell arteritis in order to avoid delay in diagnosis and therapy of this condition.

Spectrum of giant cell vasculitis

“…The response to nonsteroidal antiinflammatory drugs (NSAIDs) was poor, but was rapid with corticosteroids in dosages similar to those usually used to treat PMR [18•]. Rare clinical manifestations of GCA include presentation as an orbital pseudotumor [19], chronic cough [20], alveolitis [21], diaphragmatic weakness [22], and skeletal muscle vasculitis [23] (Table 1). …”