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Case report
Giant cell arteritis manifested by chronic dry cough
  1. Hiroshi Hori1,
  2. Tsuyoshi Kobashigawa2,
  3. Takahiko Fukuchi1 and
  4. Hitoshi Sugawara1
  1. 1Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Saitama, Japan
  2. 2Division of Rheumatology, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Saitama, Japan
  1. Correspondence to Dr Hiroshi Hori; ubm5134{at}


A 77-year-old man visited the hospital with a chronic cough persisting for 2.5 months accompanied with night sweats, weight loss (3.5 kg) and elevated C-reactive protein level. Chest CT of the lung field was normal, but aortic wall thickening accompanied by a contrast effect was noted. Positron emission tomography–CT (PET–CT) showed that the aorta and subclavian artery were inflamed, suggesting large-vessel vasculitis. Ultrasonography showed thickening of the superficial temporal artery wall (macaroni sign). Biopsy revealed lymphocytic infiltration in the tunica media and foreign-body giant cell reaction with the elastic lamina, resulting in a diagnosis of giant cell arteritis (GCA). The cough was considered a symptom of GCA as it resolved following prednisolone administration. Cough may rarely be an initial GCA symptom. However, for chronic cough accompanied with elevated inflammatory findings but with a normal lung field, imaging studies such as PET–CT are useful for the differential diagnosis.

  • vasculitis
  • immunology
  • radiology

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  • Contributors HH wrote the initial draft of the manuscript.TK, TF and HS assisted helpful discussions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.