Horton’s Disease in the Internal Medicine Department of the Donka University Hospital (Guinea-Conakry): Epidemiological, Clinical, Therapeutic and Evolutionary Profile

Introduction: Horton’s disease, also called giant cell arteritis (GCA), is an inflammatory arteritis affecting large and medium caliber arteries with predilection for the cranial branches of the arteries originating of the aortic arch and in particular the external carotid, as well as for ophthalmic arteries. It was first reported in 1890 by Hutchinson. It generally concerns the elderly with a slight female predominance, its incidence is estimated at 17.8/100,000 and 46/100,000, respectively, among subjects over 50 and 70 years old. The typical form realizes a symptomatic tripod associating headaches, more or less febrile alteration of the general state and rheumatic manifestations. THE criteria for classification of MH were determined in 1990 when of the consensus conference of the American College of Rheumatology. Temporal artery biopsy remains an essential diagnostic test. The objective of this study was to determine the prevalence of Horton’s disease in the internal medicine department of the Donka University Hospital (Guinea-Conakry). Materials and Methods: this was a retrospective study of the records of patients monitored and treated for Horton’s disease in the internal medicine department of the Donka University Hospital (Guinea-Conakry) between January 2017 and December 2022. The diagnosis of Horton’s disease was made according to the ACR criteria. Results: we included 6 patients (4 women and 2 men, is a sex ratio of 0.5). The average age of patients at diagnosis was 70 years. The main clinical manifestations found were headaches, especially temporal headaches in all patients (6 cases or 100%), followed by deterioration of general condition in 4 patients (66.66%), pseudo-polyarthritis rheumatica in 3 patients (50%) and prolonged fever in 3 patients (50%). Two patients (33.33%) had uveitis, scalp hyperesthesia and jaw claudication. Of the four patients who had a biopsy of the temporal artery, the appearance of giant cell arteritis was found in 100% of cases. Therapeutically, boluses of solumedrol (500-1000 mg/day for 3 days) were administered and the evolution was favorable in 4 patients (66.66%). Conclusion: Horton’s disease is a less diagnosed pathology due to atypical signs, temporal headaches can be the signs suggesting the disease. Eye damage is the serious complication of this condition. Biopsy of the temporal artery helps confirm the diagnosis by highlightingan infiltrationgiant cell granulomatous. Management uses corticosteroid therapy.