# Bilateral juvenile temporal arteritis: a case-based review

## TL;DR

This paper reviews a rare condition called juvenile temporal arteritis, focusing on a case with bilateral symptoms and emphasizing the importance of histopathology for diagnosis.

## Contribution

The paper provides the most extensive account of bilateral juvenile temporal arteritis cases and highlights diagnostic and clinical insights.

## Key findings

- JTA typically presents as painless or painful temporal nodules with rare systemic symptoms.
- Histopathological examination is crucial for accurate diagnosis due to the condition's variable nature.
- Some JTA cases show spontaneous regression, suggesting the need for cautious treatment approaches.

## Abstract

Juvenile Temporal Arteritis (JTA) is a rare non-granulomatous vasculitis affecting the superficial temporal arteries, mostly in individuals under 45 years old. It is often misdiagnosed due to its benign nature and the absence of systemic symptoms. Herein, we present a case report of a 40-year-old woman who initially presented with painless nodules in the left temporal area. Following a biopsy, the patient developed additional nodules not only in the same temple but also on the contralateral side. Remarkably, these nodules underwent spontaneous regression without further treatment, highlighting the variability in JTA’s course and distinctive response to intervention. In addition, through a systematic literature review of 43 case reports – 17 with bilateral involvement – we aimed to thoroughly understand the clinical and histopathological findings, diagnostic processes, and treatment responses in JTA, with an emphasis on cases with bilateral involvement. Findings indicate that JTA typically presents as painless or painful temporal nodules, rarely accompanied by other non-specific symptoms, making histopathological examination crucial for accurate diagnosis. Collectively, our work provides the most extensive account of bilateral JTA cases to date. It emphasizes the need for clinical awareness of this condition, contributes valuable data to the limited information available on this rare condition and serves as a stepping-stone for further inquiry. The main takeaway from this review is the variable nature of JTA and the importance of histopathology in diagnosis, which helps clinicians avoid excessive testing and overtreatment and anticipate possible spontaneous resolution.

The online version contains supplementary material available at 10.1007/s00296-024-05624-2.