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To the Editor.—
In "Giant Cell Arteritis With Visceral Angiitis," which appeared in the October issue of the Archives (136:1157-1160, 1976), O'Neill et al reported a case of temporal arteritis associated with visceral angiitis. In my opinion, the diagnosis is probably idiopathic arteritis or panarteritis instead, although no mention was made of this syndrome in their discussion.The diagnosis in their case was made on the basis of biopsy findings and limited arteriograms. A biopsy specimen of one of the temporal arteries showed intimal fibrosis and chronic inflammatory changes in the media and adventitia. A hepatic angiogram showed segmental constriction and dilation of several internal vessels, and there were clinical signs of inflammation of the temporal artery. The renal biopsy specimen demonstrated changes that were consistent with polyarteritis.Because of the limited nature of the diagnostic studies, the full extent of their living patient's disease could not be determined. In
James W. Milgram. Idiopathic Arteritis vs Visceral Angiitis. Arch Intern Med. 1977;137(6):812. doi:10.1001/archinte.1977.03630180084027