Giant cell arteritis with CD8+ instead of CD4+ T lymphocytes as the predominant infiltrating cells in a young woman
Chien-Sheng Wu, Kwan-Lih Hsu, Yih-Leong Chang, Kuang-Lun Lee
Department of Internal Medicine, Far East Memorial Hospital, Taipei; and Departments of Internal Medicine and Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC
Received: June 12, 2003 Revised: October 12, 2003 Accepted: October 25, 2003
Giant cell arteritis is rarely reported in people aged less than 50 years. We report a case of giant cell arteritis in a woman who developed symptoms of dizziness, headache, bilateral sensorineural hearing impairment, and had 1 episode of transient left hemiparesis before the age of 30. Carotid angiography showed multiple segmental narrowing in cranial vessels. Subsequently, at the age of 31, she had weight loss and developed a fever. Chest radiograph revealed mediastinal widening, and chest computed tomography revealed dilated pulmonary arteries and veins. Coronary angiography and aortography showed irregular narrowing of the descending aorta and multiple stenosis, with aneurysmal dilatation involving the proximal and distal coronary, pulmonary and mesenteric arteries. Multinucleated giant cells and predominant CD8+ T lymphocyte infiltration were noted in a left temporal artery biopsy specimen. The patient¡¦s age and the finding of dilated pulmonary veins and prominent CD8+ T lymphocytes in the biopsy specimen suggest that this case was a distinct form of systemic giant cell arteritis.
Aneurysm, CD8+ T-lymphocytes, giant cell arteritis, pulmonary veins, sensorineural hearing loss, Takayasu¡¦s arteritis
J Microbiol Immunol Infect 2004;37:246-249.