Is Giant Cell Arteritis a Zoster Syndrome?

Giant cell arteritis (GCA) is a vasculopathy of the external carotid and ophthalmic arteries, most frequently seen in people older than 55. The etiology remains unknown. Biopsy can be diagnostic, but suspected cases may have a nondiagnostic biopsy. To examine a possible association of GCA with varicella-zoster virus (VZV), an international coalition of investigators collected 82 GCA-positive temporal artery biopsies (TAs).

Upon review, the authors found VZV antigen in 61 (74%) of the pathologically confirmed TAs, compared with 1 of 13 healthy-control TAs — a significant difference. VZV antigen was most frequently located within “skip areas,” and giant cell vasculitis was adjacent to such areas. VZV DNA was detected by polymerase chain reacti…