Giant cell arteritis complicated by spinal cord infarction: a therapeutic dilemma.
Spinal cord involvement is uncommon in giant cell arteritis (GCA) and spinal cord infarction is extremely rare. We describe an 80-year-old man with active GCA who developed sudden paraplegia and dissociated sensory loss while receiving steroid treatment. Magnetic resonance imaging showed high signal abnormality consistent with spinal cord infarction in the anterior spinal artery territory at the level of D10. The case illustrates the elusive nature of GCA and the diagnostic and therapeutic dilemmas faced by the physician caring for these patients.
Department of Internal Medicine C, Rambam Medical Center and Bruce Rappaport Faculty of Medicine, Technion, and the Institute of Technology, Haifa, Israel.
Oren
O
Fruchter
Haim
H
Ben-Ami
Daniel
D
Schapira
Zahava
Z
Gallimidi
Diana
D
Gaitini
Dorit
D
Goldsher
D000368:Aged; D000369:Aged, 80 and over; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D013700:Giant Cell Arteritis / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007238:Infarction / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008775:Methylprednisolone / Q000008:administration & dosage*; D011241:Prednisone / Q000008:administration & dosage*; D018570:Risk Assessment; D013116:Spinal Cord / Q000098:blood supply*; D020760:Spinal Cord Ischemia / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D016896:Treatment Outcome
D011241:Prednisone; D008775:Methylprednisolone; D008727:Methotrexate