Gender differences in giant cell arteritis: a case-control study.

Objectives: To determine sex differences in the clinical spectrum and disease pattern of cranial and extracranial giant cell arteritis (GCA).

Methods: Data on 153 consecutive patients with a confirmed diagnosis of GCA between 2002 and 2013 were retrospectively obtained from our database. For every male patient, two age-matched female patients were identified. Clinical symptoms, vascular physical examination findings, laboratory values, and the disease patterns as assessed by colour duplex sonography of the temporal and axillary arteries were compared between women and men. Subgroup analyses were performed for patients aged 50-69 years and ≥70 years at disease onset.

Results: No significant differences between sexes were noted with regard to cranial GCA. Female patients significantly more frequently had axillary artery involvement (48.9 vs. 27.5%, p=0.03), a difference mainly driven by a higher rate of axillary artery involvement in women ≥70 years of age (38.6 vs. 4.5%, p<0.01). Women aged 70 years or older significantly more frequently had axillary artery stenosis (27.3 vs. 0%, p<0.01), symptoms of upper extremity ischaemia (20.5 vs. 0%, p<0.01), and polymyalgia rheumatica (36.4 vs. 9.1%, p=0.02) compared to men. Significant sex differences were observed with regard to the frequency of anaemia and the mean platelet count.

Conclusions: In GCA involvement of the cranial arteries does not differ between sexes. Female patients with GCA significantly more frequently exhibit extracranial (i.e. axillary) arterial involvement than men.