Sex differences in giant cell arteritis

Objective. Although it has been suggested that sex differences underlie the varying presentation of giant cell arteritis (GCA), this has not been proven. We compared medical history, symptoms, and signs in patients with GCA and polymyalgia rheumatica (PMR). Methods. We performed a retrospective study in the Hadassah University Hospitals in Jerusalem, Israel. We evaluated medical data of 88 patients (59 women, 29 men) admitted with the diagnosis of GCA or PMR between 1980 and 1998. Results. Comparison of comorbidities among patients showed that non-insulin dependent diabetes mellitus, cerebrovascular accidents, and chronic renal failure are more prevalent in men, while hypertension has a trend to be more prevalent in women. In the clinical presentation of the disease, eye involvement is more prevalent in men, with a tendency towards blindness. Women tend to have higher prevalence of jaw involvement and complaints of polymyalgia. The sexes also seem to differ with respect to laboratory presentation of the disease. Conclusion. Men and women with GCA and PMR differ in their history, presentation, and laboratory findings. Our results recommend a more aggressive approach to male patients in view of the higher prevalence of severe eye involvement and blindness.