Clinical and pathological study of 6 cases of giant cell arteritis and literature review

WEI Roufan; QIU Yuhan; JIAO Wanting; LI Zhiwei; ZHANG Weixuan; ZHANG Wei

doi:10.3969/j.issn.1007-8096.2025.09.017

Abstract：Objective To explore the clinicopathological characteristics and diagnostic key points of giant cell arteritis(GCA),thereby enhancing the understanding and diagnostic accuracy of this disease.Methods A retrospective analysis was conducted on the clinical data,laboratory findings,and histopathological features of 6 patients with pathologically confirmed GCA.The results were reviewed and summarized in conjunction with relevant literature.Results The cohort included 2 male and 4 female patients,aged 69-76 years(mean;72).Clinically,all 6 patients presented with unexplained headaches accompanied by temporal artery tenderness(5/6 cases),visual disturbances(1/6),jaw claudication(2/6),polymyalgia rheumatica(3/6),low-grade fever(3/6),fatigue(2/6),and altered consciousness(1/6).Laboratory tests revealed elevated inflammatory markers,including significantly increased erythrocyte sedimentation rate(ESR)and hypersensitive C-reactive protein(hs-CRP).The histopathological findings revealed intimal hyperplasia with mucoid degeneration and luminal stenosis in the arteries.Fragmentation of the internal elastic lamina was observed,accompanied by prominent mononuclear cell infiltration and a multinucleated giant cell reaction.Small granulomas were identified in some cases.The external elastic lamina demonstrated lymphocyte infiltration with scattered multinucleated giant cell reaction.All patients received maintenance therapy with glucocorticoids combined with immunosuppressive agents,resulting in significant clinical improvement.No disease recurrence was documented during the follow-up period.Conclusion The nonspecific clinical manifestations of GCA may lead to misdiagnosis or underdiagnosis.Early temporal artery biopsy for histopathological evaluation is critical for definitive diagnosis and timely intervention.