A Rare Case of Aortic and Cardiac Thrombosis Revealing a Horton's Disease: Clinical Presentation, Diagnostic Challenges and Therapeutic Considerations

Sami Belkouchia *

Cardiology Department, IBN ROCHD University Hospital, Casablanca, Morocco.

Zineb Amine

Cardiology Department, IBN ROCHD University Hospital, Casablanca, Morocco.

Zaid Ammouri

Cardiology Department, IBN ROCHD University Hospital, Casablanca, Morocco.

Meryem Haboub

Cardiology Department, IBN ROCHD University Hospital, Casablanca, Morocco.

Rachida Habbal

Cardiology Department, IBN ROCHD University Hospital, Casablanca, Morocco.

*Author to whom correspondence should be addressed.


Abstract

Horton's Disease, also known as Giant cell arteritis is a disease of the blood vessels predominantly affecting medium and large-sized arteries mainly the branches of the aorta and its main vessels. In these patients, there is an increased cardiovascular risk for the development of both arterial and venous thromboembolism. In this case report we discussed a rare case of aortic and cardiac thrombosis associated with Horton's disease which is quite unusual. Early diagnosis is mandatory as the prognosis of this disease mainly depends on timely management. Horton's disease should be suspected in people aged above 55 years as this disease is unlikely and rare in people aged less than 55 years and females are more affected by this disease (men to women ratio is 2:1). This rare case highlights the importance of considering unusual and infrequent associations of this disease and accordingly tailoring the treatment strategies for optimal patient outcomes. decrease medical as well as financial burden, hence improving the management of cirrhotic patients. These predictors, however, need further work to validate reliability.

Keywords: Horton’s disease, thrombosis, cardiology, autoimmune, giant cell arteritis


How to Cite

Belkouchia, Sami, Zineb Amine, Zaid Ammouri, Meryem Haboub, and Rachida Habbal. 2024. “A Rare Case of Aortic and Cardiac Thrombosis Revealing a Horton’s Disease: Clinical Presentation, Diagnostic Challenges and Therapeutic Considerations”. Asian Journal of Cardiology Research 7 (1):52-57. https://journalajcr.com/index.php/AJCR/article/view/200.

Downloads

Download data is not yet available.

References

Weyand CM, Goronzy JJ. Clinical practice. Giant-cell arteritis and polymyalgia rheumatica. The New England Journal of Medicine. 2014;371(1):50-7.

Weyand CM, Liao YJ, Goronzy JJ. The immunopathology of giant cell arteritis: Diagnostic and therapeutic implications. Journal of Neuro-ophthalmology: The Official Journal of the North American Neuro-Ophthalmology Society. 2012;32(3): 259-65.

Gomułka K, Radzik-Zając J, Zaleska-Dorobisz U, Panaszek B. Horton's disease: Still an important medical problem in elderly patients: A review and case report. Postepy Dermatologii I alergologii. 2017; 34(5):510-3.

Muratore F, Crescentini F, Spaggiari L, Pazzola G, Casali M, Boiardi L et al. Aortic dilatation in patients with large vessel vasculitis: A longitudinal case-control study using PET/CT. Seminars in Arthritis and Rheumatism. 2019;48(6):1074-82.

de Boysson H, Daumas A, Vautier M, Parienti J-J, Liozon E, Lambert M et al. Large-vessel involvement and aortic dilation in giant-cell arteritis. A multicenter study of 549 patients. Autoimmunity Reviews. 2018;17(4):391-8.

Salvarani C, Soriano A, Muratore F, Shoenfeld Y, Blockmans D. Is PET/CT essential in the diagnosis and follow-up of temporal arteritis? Autoimmunity Reviews. 2017;16(11):1125-30.

Maleszewski JJ, Younge BR, Fritzlen JT, Hunder GG, Goronzy JJ, Warrington KJ et al. Clinical and pathological evolution of giant cell arteritis: A prospective study of follow-up temporal artery biopsies in 40 treated patients. Modern Pathology. 2017; 30(6):788-96.

Stone JR, Bruneval P, Angelini A, Bartoloni G, Basso C, Batoroeva L et al. Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases. Cardiovascular Pathology. 2015;24(5):267-78.

Ness T, Bley TA, Schmidt WA, Lamprecht P. The diagnosis and treatment of giant cell arteritis. Deutsches Arzteblatt international. 2013;110(21):376-85;quiz 86.

Vaith P, Warnatz K. [Clinical and serological findings of giant-cell arteritis]. Zeitschrift fur Rheumatologie. 2009;68(2): 124-31.

Weyand CM, Goronzy JJ. Immunology of giant cell arteritis. Circulation research. 2023;132(2):238-50.

Jakobsson K, Jacobsson L, Warrington K, Matteson EL, Liang K, Melander O et al. Body mass index and the risk of giant cell arteritis: Results from a prospective study. Rheumatology (Oxford, England). 2015; 54(3):433-40.

Wadström K, Jacobsson L, Mohammad AJ, Warrington KJ, Matteson EL, Turesson C. Negative associations for fasting blood glucose, cholesterol, and triglyceride levels with the development of giant cell arteritis. Rheumatology (Oxford, England). 2020; 59(11):3229-36.

Weyand CM, Hicok KC, Hunder GG, Goronzy JJ. The HLA-DRB1 locus is a genetic component in giant cell arteritis. Mapping of a disease-linked sequence motif to the antigen binding site of the HLA-DR molecule. The Journal of Clinical Investigation. 1992;90(6):2355- 61.

Weyand CM, Hunder NN, Hicok KC, Hunder GG, Goronzy JJ. HLA-DRB1 alleles in polymyalgia rheumatica, giant cell arteritis, and rheumatoid arthritis. Arthritis and Rheumatism. 1994;37(4):514-20.

Carmona FD, Mackie SL, Martín JE, Taylor JC, Vaglio A, Eyre S et al. A large-scale genetic analysis reveals a strong contribution of the HLA class II region to giant cell arteritis susceptibility. American Journal of Human Genetics. 2015;96(4): 565-80.

Ness T, Auw-Hädrich C, Schmidt D. [Temporal arteritis (giant cell arteritis). Clinical picture, histology, and treatment]. Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 2006;103(4):296-301.

Kale N, Eggenberger E. Diagnosis and management of giant cell arteritis: A review. Current Opinion in Ophthalmology. 2010;21(6):417-22.

Chrysidis S, Døhn UM, Terslev L et al: Diagnostic accuracy of vascular ultrasound in patients with suspected giant cell arteritis (EUREKA): A prospective, multicentre, non-interventional, cohort study. The Lancet Rheumatology. 2021; 3(12):e865-e873. DOI:org/10.1016/S2665-9913(21)00246-0

Nuenninghoff DM, Hunder GG, Christianson TJ, McClelland RL, Matteson EL. Incidence and predictors of large-artery complication (aortic aneurysm, aortic dissection, and/or large-artery stenosis) in patients with giant cell arteritis: A population-based study over 50 years. Arthritis and Rheumatism. 2003;48(12): 3522-31.