Progressive visual loss in a patient with presumed temporal arteritis despite treatment: how to make the diagnosis.
Giant cell (temporal) arteritis is a severe potentially fatal systemic vasculitis characterized by focal involvement of the cranial arteries resulting in ischaemic arterial occlusion. The case is presented of a 75-year-old woman with presumed giant cell arteritis and normal bilateral temporal artery biopsies. Despite a seemingly adequate course of systemic steroid therapy, the patient developed sudden catastrophic vision loss. Cerebral angiography and ultrasonography were useful investigations to determine the most appropriate artery to biopsy to confirm the diagnosis of giant cell arteritis.
Zborowska
Bogna
B
Ell
Jonathan
J
McGhee-Collett
Martin
M
Scolyer
Richard
R
McCluskey
Peter J
PJ
D000368:Aged; D001706:Biopsy; D002342:Carotid Artery, External / Q000000981:diagnostic imaging / Q000473:pathology; D018450:Disease Progression; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D018917:Optic Neuropathy, Ischemic / Q000175:diagnosis* / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D011859:Radiography; D013699:Temporal Arteries / Q000187:drug effects / Q000473:pathology*; D014786:Vision Disorders / Q000175:diagnosis* / Q000188:drug therapy; D014792:Visual Acuity
D005938:Glucocorticoids; D011239:Prednisolone; D008775:Methylprednisolone