A 75-year-old man has experienced headaches for the past 2 months. On physical examination, his vital signs are temperature, 37deg C; pulse, 68/min; respirations, 15/min; and blood pressure, 130/85 mm Hg. His right temporal artery is prominent, palpable, and painful to the touch. His heart rate is regular, and there are no murmurs. His erythrocyte sedimentation rate is 100 mm/hr. A temporal artery biopsy is performed, and the segment of the temporal artery excised is grossly thickened and shows focal microscopic granulomatous inflammation. He responds well to corticosteroid therapy. Which of the following complications of this disease is most likely to occur in untreated patients?
Giant cell (temporal) arteritis typically involves large to medium-sized external carotid artery branches in the head (especially temporal arteries), but also vertebral and ophthalmic arteries. The involvement of the latter can affect vision. Because the involvement of the kidney, lung, and peripheral arteries of the extremities is much less common, renal failure, hemoptysis, and gangrene of toes are unusual complications of giant cell arteritis. There is no association between hypertension and giant cell arteritis, but some patients may have polymyalgia rheumatica.
Blindness
Gangrene of the toes
Hemoptysis
Malignant hypertension
Blood Vessels