Giant cell aortitis: a difficult diagnosis assessing risk for the development of aneurysms and dissections

A significant location affected by giant cell (GC) arteritis is the ascending aorta, where aneurysms may develop and catastrophic ruptures and acute dissections can occur. Herein, we discuss three cases of GC aortitis discovered at pathological examination of surgically excised aortic aneurysmal tissue. There was no clinical suspicion of any underlying inflammatory process. We describe the main clinical features of the patients in conjunction with a review of the literature to identify any common clinical presentations that manifest in these patients. Giant cell aortitis in the absence of previously established GC arteritis is difficult to identify, and a careful analysis of the history and presentation along with appropriate investigations (e.g., erythrocyte sedimentation rate) may prompt the clinician to consider GC aortitis and suggest immunosuppressant therapy.