Polymyalgia rheumatica and giant cell arteritis--An ophthalmic emergency.
BACKGROUND
The occurrence of giant cell arteritis (GCA) in the setting of polymyalgia rheumatica (PMR) is not uncommon. It is imperative to recognise the symptoms and signs of GCA in this setting as the treatment of PMR with low dose corticosteroids will not protect the patient against the blinding consequences of GCA.


OBJECTIVE
This article reports the case of a woman with PMR who developed sudden and irreversible vision loss due to GCA.


CONCLUSIONS
It is important to recognise GCA in patients with PMR before the onset of permanent visual disability. A rising erythrocyte sedimentation rate in such patients may herald the onset of GCA. Other risk factors for GCA include age over 50 years, female gender, symptoms of ischaemia, and temporal artery abnormalities on examination. The latter two features warrant urgent ophthalmic or rheumatological review.
Durkin
Shane R
SR
Royal Adelaide Hospital, South Australia. shane_durkin@yahoo.com
Athanasiov
Paul A
PA
Crompton
John L
JL
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001766:Blindness / Q000517:prevention & control*; D001799:Blood Sedimentation; D002097:C-Reactive Protein; D004630:Emergencies; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D011111:Polymyalgia Rheumatica / Q000150:complications* / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D002097:C-Reactive Protein; D011239:Prednisolone