Temporal artery vasculitis (TAV) in patients younger than 50 years is extremely rare. A case of TAV in an 18-year-old man is described here, followed by a literature review regarding cases of all types of vasculitic involvement of the temporal arteries in the young.
Methods
Review of the English literature on vasculitis involving the temporal arteries in young patients, based on a PubMed search.
Results
Less than 40 cases of vasculitic involvement of temporal arteries in the young have been described. TAV in the young may be divided into 3 groups: juvenile temporal arteritis, a localized eosinophilic arteritis confined to the temporal arteries, seems unique to this age group. Fifteen patients with juvenile temporal arteritis were described. Other vasculitides, such as polyarteritis nodosa, Churg–Strauss syndrome, and thrombangiitis obliterans may involve the temporal arteries in young patients. The literature search revealed 12 such cases. The least common group is arteritis in young patients, histologically resembling elderly type temporal arteritis, featuring 5 cases. In addition, other conditions such as Kimura disease and angiolymphoid hyperplasia with eosinophilia may resemble temporal arteritis in the young.
Conclusions
TAV in the young is rare and differs from the classical temporal arteritis of older adults. There is an apparent overlap among several vasculitic conditions involving the temporal arteries in the young, and histological distinction may be difficult at times. The final diagnosis of the different conditions causing TAV in the young is based on a combination of clinical findings, relevant laboratory data, imaging studies, and histological findings.
⁎Department of Internal Medicine, Rheumatology Service, Shaare-Zedek Medical Center, Jerusalem, Israel Clinical Associate Professor of Medicine, the Hebrew University Medical School, Jerusalem, Israel Adjunct Professor, St. Louis University School of Medicine, St. Louis, MO
†Department of Rheumatology, Sourasky Medical Center, Tel-Aviv, Israel
‡Department of Pathology, Shaare-Zedek Medical Center, Jerusalem, Israel
§Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel; Lecturer, Sackler Medical School, Tel-Aviv University, Tel-Aviv, Israel
Address reprint requests to Gideon Nesher, MD, Department of Internal Medicine A, Shaare-Zedek Medical Center, P.O. Box 3235, Jerusalem 91031, Israel
ABSTRACT