MALADIE DE HORTON

Abstract

Horton's disease classically associates headaches, an alteration of the general condition, local temporal signs and rhizomelic pseudopolyarthritis. In fact, the systemic signs are often predominant and temporal artery biopsy is one of the first examinations which should be performed in cases of prolonged, unexplained fever in an elderly person. Amongst the laboratory findings, the inflammatory syndrome is often pronounced and constitutes an essential diagnostic and evolutive criterion. Liver function tests may also be abnormal and can be a source of diagnostic error. In 1982, blindness remained the major complication of Horton's disease; it is sometimes preceded by visual prodromes which are an indication for immediate steroid therapy. Because of the segmental nature of the arterial lesions, the histological confirmation of the diagnosis is sometimes difficult to obtain, although, today, the site of the biopsy can be guided by Doppler ultrasound. Steroids constitute the treatment of choice of Horton's disease. They are often administered for many years which increases the risks to these elderly subjects who are already at risk of osteoporosis and atheroma.