Volume 37, Number 4, August 2004
| | Giant cell arteritis with CD8+ instead of CD4+ T lymphocytes as the predominant infiltrating cells in a young woman |
Chien-Sheng Wu1, Kwan-Lih Hsu2, Yih-Leong Chang3, Kuang-Lun Lee2
1Department of Internal Medicine, Far East Memorial Hospital, Taipei; and Departments of 2Internal Medicine and 3Pathology, 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
Corresponding author: Dr. Kuang-Lun Lee, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan 100, ROC. E-mail:
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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.
Key words: Aneurysm, CD8+ T-lymphocytes, giant cell arteritis, pulmonary veins, sensorineural hearing loss, Takayasu¡¦s arteritis
J Microbiol Immunol Infect 2004;37:246-249.
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