title: Giant-cell arteritis with normal erythrocyte sedimentation rate: case report and review of the literature.
abstract: A high Erythrocyte Sedimentation Rate (ESR) is often seen as a sine qua non for the diagnosis of giant-cell arteritis. The percentages of histopathologically proven giant-cell arteritis associated with a normal ESR, however, are variously reported as 5 to 30%. We describe a patient with histopathologically proven giant-cell arteritis and a normal ESR. A review of literature identified 34 cases of giant-cell arteritis who showed a normal ESR. Their clinical symptoms and signs are compared with the characteristics of patients with giant cell arteritis and an elevated ESR. No distinctive clinical features were found. A normal ESR cannot be used to exclude the diagnosis of giant-cell arteritis.
authors.affiliation: Department of Internal Medicine, Free University Hospital, Amsterdam, Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Zweegman
authors.forename: B
authors.initials: B
authors.lastname: Makkink
authors.forename: C D
authors.initials: CD
authors.lastname: Stehouwer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001799:Blood Sedimentation; D005260:Female; D013700:Giant Cell Arteritis / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D006261:Headache / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged