Vasculitis of the Temporal Arteries in the Young

Objective

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.

Keywords: temporal arteritis, juvenile, vasculitis, eosinophils, angiolymphoid hyperplasia, Kimura disease