A Rare Cause of Pericardial Effusion: Giant Cell Arteritis

Giant cell arteritis is a granulomatous vasculitis characterized by medium or large sized vessel involvement. Although extracranial branches of the carotid artery are typically involved, involvement of aorta and its major branches can also be seen. Cardiac involvement has been encountered less frequently and pericardial effusion is rarely encountered. In this paper, a case has been presented in which pericardial effusion was determined during the examination and diagnosis was giant cell arteritis. 1. Introduction Giant cell arteritis (GCA), also called temporal arteritis, is granulomatous vasculitis of major vessel. It is generally observed after 50 years of age and ratio of female/male patients is 2–4/1. It involves especially extracranial branches of carotid artery [1]. Based on this involvement, newly started headache, claudication in jaw and tongue, visual impairment symptoms, and temporal artery sensitivity develop. In addition, nonspecific systemic symptoms such as fever, weight and appetite loss, and fatigue may also appear as the initial symptoms of the disease. In about half of the patients, symptoms of polymyalgia rheumatica accompany the clinical manifestation [2]. Cardiac involvement is rare in GCA. Myocardial infarction and aortic aneurysm are serious manifestations that may arise [3–5]. Pericardial involvement in GCA is quite rare. In the present case, we report a GCA with pericardial effusion who had nonspecific symptoms such as weight loss and fatigue at first presentation. 2. Case Presentation A 74-year-old female patient applied to our clinic with the complaints of fatigue, loss of appetite, weight loss. She had lost five kg in the last two months during which she had the complaints. In tests conducted by another center, high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values had been detected, and for evaluation she was referred to our hospital with malignity and infection prediagnoses. When detailed anamnesis was taken, she was found to have complaints of fever, one-sided headache, and claudication. She had no diseases other than hypertension from which she had suffered for 10 years. Physical examination determined the following findings: body temperature, 36.8°C; heart rate, 80 beats/min and rhythmic; blood pressure, 130/80？mmHg. Left temporal artery was tender with palpation and scalp was aching. There was no pathological finding in lung and cardiac examination. In abdominal examination, there was no abnormality other than slight tenderness in right, upper quadrant upon deep palpation. Other system